New at Rambam: Clinic for Treating Narrowing Carotid Arteries and Stroke Prevention
January 17, 2021 – A new clinic is the first of its kind in Northern Israel, providing treatment for narrowing carotid arteries and stroke prevention that was, until now, unavailable in this part of the country.
Rambam Health Care Campus has inaugurated a clinic for treating narrowing of the carotid arteries and stroke prevention, which operates within the framework of the hospital’s Stroke and Cognition Institute. This is a common medical condition estimated to cause about 15% of strokes.
As part of the new clinic, patients can receive an evaluation by a vascular neurologist and customized intensive drug treatment, as well as an assessment of the need for intervention and treatment of stenosis (abnormal narrowing in a blood vessel or other tubular organ). The clinic operates in cooperation with Rambam’s Department of Vascular Surgery as well as the hospital’s Invasive Neuroradiology Unit (brain catheterization). “I see and understand the great importance of the need for a dedicated clinic in the north for the treatment of narrowing carotid arteries and stroke prevention, “says Professor David Tanne, Director of the Stroke and Cognition Institute, who also serves as Chairman of the Israel Neurological Association. “This is an important preventive service that can impact the health of many people, avoid disability, and save lives.”
The carotid arteries are the two major arteries that pass through the neck and supply blood to the brain. Narrowing of these arteries is common in the area where they split off, especially among those with a family history of vascular disease, high cholesterol and blood lipids, hypertension, diabetes, obesity, inactivity, and chronic kidney disease.
Carotid artery stenosis is caused by atherosclerosis, a condition in which substances such as high-cholesterol lipids, inflammatory cells, and cellular debris settle in the artery walls, which, over time cause plaque; the build-up eventually leads to narrowing of the arteries.
In some cases, there is a quiet, unexplained stenosis of the carotid arteries. This does not actually cause strokes or mini-strokes. However, particles on the sclerosing plaque can detach and enter the bloodstream, thereby blocking cerebral blood vessels, and causing a stroke. In fact, about 15% of strokes are attributed to moderate or severe narrowing of the internal carotid arteries in the neck.
Treatment of severe carotid artery stenosis is performed by removing the atherosclerotic plaque from the carotid artery during surgery. An alternative option is catheterization and installation of a stent in the narrowed artery.
In addition to surgical solutions, in recent years there have been important breakthroughs in intensive, personalized drug therapy for effectively reducing blood lipids, in particular LDL cholesterol levels (“bad cholesterol”), as well as for balancing sugar levels in diabetes, high blood pressure, and anticoagulation treatments for platelet disorders.
Cracking the Treatment: Rambam Participates in a Prestigious International Study to Prevent Brain Events
Meanwhile, Rambam is the only hospital in Northern Israel to participate in an important, prestigious international research project on behalf of the American National Institutes of Health (NIH) and the Mayo Clinic. The study is comparing a balanced and intensive medication management program with intensive medical care combined with surgical removal of atherosclerotic plaque from the carotid arteries. The study is aimed at determining the safest and most effective way to prevent strokes among at-risk populations.
According to Professor Tanne, engagement in this research is not only a privilege – it is also a duty. “As doctors working in a leading medical center, we are committed to public health, not only at the clinical level but also in the field of research. This is part of Rambam’s vision and practice. It is important to understand the mechanisms and optimal treatment for the diseases we treat on a daily basis. The collaboration we are currently pursuing with the leading players in the United States is part of an important and prestigious study that could yield a therapeutic breakthrough and bring good news to millions of people.”
In the photo: Professor David Tanne.
Photography courtesy of Rambam Health Care Campus.