Another Doc Accused of Unnecessary Carotid Artery Stenting

Just before Christmas yet another doctor was accused of performing unnecessary carotid artery stenting procedures on patients. The kicker? This doctor was actually a member of a Maryland task committee assigned to reduce this type of unnecessary invasive carotid artery stenosis treatment.

A complaint was filed early in December 2011 against Dr. John Chung-Yee Wang alleging that he wrongfully stented one patient and exaggerated the extent of carotid artery stenosis in another to justify a stent placement.

Dr. Wang is a part of the Technical Advisory Group on Oversight of Percutaneous Coronary Intervention Services which was appointed by the Maryland Healthcare Commission to improve cardiovascular interventions oversight and reduce unnecessary invasive procedures. The committee was set to report its findings shortly after the complaint was filed against Dr. Wang, significantly reducing the value of their report.

Dr. Wang was previously partners with Dr. Mark Midei who had his medical license revoked earlier in 2011 after an investigation revealed that he wrongfully performed carotid artery stenting procedures on hundreds of patients.

Dr. Wang and Dr. Midei are just two of many doctors who have come into the spotlight in these last few years under allegations of inappropriate carotid artery stenosis treatments. The rise of these occurrences has promoted the medical community to increase their discussions on developing more clear guidelines on the treatment of carotid artery stenosis – particularly in patients who are non-symptomatic. While some in the medical community believe that stenting interventions are the best form of treatment, others believe that recent advancements in medical management strategies are safer for patients in the long run .

For more information about the safety of carotid artery stenting or to talk with a doctor about whether or not this procedure is right for you talk with a professional at Cardiovascular Institute of Northwest Florida also known as Cardiology Associates here: Cardiologist in Florida

Fish Consumption Wards off Carotid Artery Stenosis in Women

Among women of childbearing age heart risks, such as carotid artery stenosis, can be avoided by eating fish at least once per week.

According to Danish researchers, women who never consume fish rich in omega-3 fatty acids have up to a 50% increase in cardiovascular disease compared to women who consume it regularly. Even more surprising, they have a 90% increase compared to women who eat fish on a weekly basis.

“We found that even women who ate fish only a couple of times a month benefited,” said lead researcher Marin Strom, a postdoctoral fellow at the Center for Fetal Programming at the Statens Serum Institute in Copenhagen

Cardiovascular disease is a growing problem among women and is responsible for 8.6 million female deaths worldwide each year. Carotid artery stenosis, a form of heart disease, is the building up of plaque on the walls of the carotid arteries which can lead to stroke. While carotid artery stenting is a way to prevent stroke from occurring, prevention is the key to saving lives.

The study, which was published in the the December 5, 2011 edition of the journal Hypertention included over 49,000 women who were given questionnaires about their lifestyle, eating habits, and family medical history. While there was a strong association found between fish consumption and carotid artery stenosis and other heart disease risk, the researchers say this does not necessarily prove cause and effect.

“Women who eat fish should find the results encouraging,” said Strom. “But it is important to emphasize that to obtain the greatest benefit from fish and fish oils, women should follow the dietary recommendations to eat fish as a main meal at least twice a week.”

Women who are looking to reduce their risk for heart disease and the need for carotid artery stenosis treatment should be sure that they make omega-3 rich fish the main course for at least two meals per week. This includes salmon, sardines, mackerel, etc. Women who are pregnant or otherwise unable to consume high amounts of fish may want to talk with their healthcare providers about taking an omega-3 supplement.

Radiation Increases Risk for Carotid Artery Stenosis

Many neck and head cancer patients receiving radiation treatment show asymptomatic stenosis and within three years resort to carotid artery stenting.

The factors that are associated with risk for stenosis include smoking, hypertension, hyperlipidemia, diabetes mellitus, cardiovascular or peripheral vascular disease, atrial fibrillation, and radiation.

Radiation oncologists at Duke University Medical Center in Durham, North Carolina discovered that among 225 patients who had received radiation and were screened for stenosis, an estimated 18% had significant asymptomatic stenosis (50% or greater narrowing) of one or both carotid arteries 3 years after treatment.

Followings these findings, disease-free head and neck cancer patients who had received radiation around the neck were screened with carotid Doppler ultrasound at or after the 1-year afterwards, and this was repeated every 2-3 years. Patients with ultrasound evidence of 50% or greater stenosis were referred to vascular surgery.

For more information on vascular disease risk factors and carotid artery stenting visit Carotid Artery Stenosis Screening Recommended for High Risk Patients

Soy Protein Decreases Carotid Artery Stenosis in Women

Carotid artery stenosis, the narrowing or constriction of the carotid artery, is a major cause of stroke, a problem affecting at least 731,000 people in the United States. Atherosclerosis, which is also known as hardening of the arteries, generally is at the source of this condition.

A recent study conducted by researchers at the USC Keck School of Medicine reveals that by having a diet rich in soy protein reduces the development of atherosclerosis by 16% in postmenopausal women. Among women who experienced menopause within the past five years, the reduction increase to 68%. All the women tested did not have diabetes or heart disease and the study was conducted by giving a daily dose of 25g of soy protein over the course of 2.7 years. Given the connection of atherosclerosis to carotid artery stenosis, this study has greater implications for stroke.

Soy is an excellent source of protein that is free from the heavy saturated fat found in animal protein. Substituting animal protein with vegetable protein can also be an effective way to lower blood cholesterol.

Currently there is no recommended daily allowance for soy protein, however, the FDA has declared that “25 grams of soy protein a day as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease”. It is possible to reach this limit by consuming 2-3 servings of most soy foods per day.

Fortunately, there are a variety of ways to incorporate soy into your diet, such as dried soy nuts, edamane beans, tofu, soy burgers, soy milk, dehydrated soy to make red sauce in place of meat, and soy powder to add to fruit smoothies. There is even soy ice cream. Soy is very versatile and a variety of flavorings can easily be added and combined to suit your taste buds.

Eating soy alone will not be enough to prevent carotid artery stenosis and stroke all together, but it certainly proves an effective practice to incorporate into other health promoting routines, such as daily moderate exercise.

Stroke Prevention: Carotid Artery Stents vs. Medical Therapy

A new study has found that Carotid Artery Stenosis might not be as effective as medical therapy in stroke prevention. The study found that the risk of stroke after carotid artery stenting was much higher than was originally thought; and at the same time the results of medical therapy for stroke prevention were much better than they had expected.

A stroke occurs when the blood supply to the brain is cut off or significantly reduces. Doctors have been increasingly using stents, especially in patients who have already had a stroke and run the risk of a second stroke occurring in the same place as the first. Carotid artery stenting involves the insertion of a small balloon into the blocked carotid artery to open up the artery and therefore the blood supply to the brain. Previous trials have shown it is a relatively safe procedure, however, it now seems that it might not be as safe as we think.

The trial, published online on September 7th in the New England Journal of Medicine, found that carotid artery stenosis was associated with more strokes and death than medical therapy. Carotid artery stenosis is an extremely advanced surgery that requires highly trained surgeons, therefore, its success is far from guaranteed. It seems that the insertion of the stent could in fact be damaging the artery and causing a stroke. This was also found to be the case in brain stents which were damaging the blocked blood vessels in the brain upon insertion, resulting in strokes as opposed to preventing them.

Medical therapy, on the other hand, involves aspirin, clopidogrel, management of LDL and blood pressure, to prevent strokes. This turned out to be a far safer and more effective treatment than they had thought. Therefore, perhaps medical therapy is the best option for high risk patients than carotid artery stenting which, far from preventing stroke, might actually be causing them.

Pregnancy in Older Women: Protecting the Heart

Did you know that pregnancy puts an enormous strain on heart and cardiovascular system? In fact, during pregnancy a woman’s blood volume increases by up to 50% making your heart work extra hard with each beat to circulate blood through your body and to your baby.

With pregnancy in older women, the risk for additional heart strain is much greater than those of younger women. As we get older, the risk for heart disease naturally increases. If you have had a lifelong diet high in cholesterol and fat in addition to minimal exercise, your risk for heart disease is greater than a women of the same age who has maintained healthy habits

The rise of delayed family planning and infertility treatments have made pregnancy at 40 or even pregnancy at 45 much more common – meaning that more and more women need to pay attention to their heart health before and during pregnancy.

Unfortunately, it is often during pregnancy that many women discover that they have undiagnosed heart conditions that they did not previously know about. The most commonly diagnosed heart issues during pregnancy include abnormal heart rhythm or heart valves, congestive heart failure or congenital heart defects. In older women, the risk for atherosclerotic heart disease (hardening of the arteries) is also more common, placing the women at significant risk for a heart attack or stroke during pregnancy, labor and delivery.

Older women who are experiencing, or plan to experience, a pregnancy at 40 or pregnancy at 45 should make sure they speak with a cardiologist Bay County FL, to make sure that they have a thorough cardiology exam.

Should heart disease be diagnosed prior to pregnancy certain medications or procedures such as carotid artery stenting could help decrease a woman’s risk for heart attack or stoke. However, if this heart condition is diagnosed during pregnancy often treatments are limited to very few types of medication and strict bed rest.

Stroke Prevention: Brain Stents vs. Carotid Stents

According to the Centers for Disease Control and Prevention (CDC), stroke is the third leading cause of death and the leading cause of serious long-term disability in the U.S. Therefore, with various new treatments emerging to combat this huge problem, how do we decide which can be trusted to save millions of lives?

Bran stents were approved a in 2005, and past studies have supported their effectiveness against stroke. Brain stents are used to open up clogged arteries, enabling blood to flow freely, thus preventng a stroke. However, recent studies tell a different story. More often than not, these brain stents are damaging the blood vessels upon insertion which is having the reverse effect of actualy causing strokes and even death.

However, Michael J. Alexander, MD, from Cedars-Sinai Medical Center in Los Angeles, who was involved brain stent trials, believes they can still be of value. In some patients, particularly those for whom drugs have been ineffective, brain stents are still a viable option. Therefore, even though they have emerged as a potentially fatal treatment, it seems they won´t be discarded entirely. In some desperate cases they might just be the best option.

Carotid stents, on the other hand, are small balloons inserted into the carotid artery as a treatment for carotid artery stenosis treatment to faclitate blood flow to the brain. Unlike brain stents, there has not been any recent trials to suggest they shouldn´t be used in stroke prevention. However, it is still a complex procedure that requires the skills of a highly qualified cardiologist.

After considering both types of treatment, carotid artery stenting definately seem to be the safer option. However, I would opt for the more conventional treatment of an aggressive course of medcation which, for now, is perhaps the safer alternative to these complex and potentially life-threatening treatments.