New Procedure To Prevent Strokes Performed For First Time in Georgia
at Emory University Hospital
People who are
at risk for stroke due to the heart rhythm disturbance known as atrial
fibrillation (AF) -- and who can't take blood thinners to prevent the
blood clots that cause stroke -- may one day have their stroke risk
virtually eliminated during a 90 minute outpatient procedure.
Emory cardiologists are participating
in a multi-center study of new technology, known as PLAATO (Percutaneous
Left Atrial Appendage Transcather Occlusion), that uses a tiny implantable
device to prevent stroke by eliminating the source of blood clots that
frequently cause stroke in people with AF.
Developed by Appriva Medical
Inc., the PLAATO device is shaped like a miniature cage and covered
with Gore-Tex. A small catheter threaded into the heart deposits the
device into a pouch-like appendage attached to the upper chamber of
the heart where blood clots are known to form in AF patients. "By permanently
occluding this structure, clots that develop there are unable to break
off, travel to the brain and result in stroke," explains Emory Heart
Center interventional cardiologist Peter Block, M.D., who is heading
the PLAATO research team at Emory.
The procedure offers new
hope to people at risk of stroke from atrial fibrillation. Affecting
approximately 2.2 million Americans, AF results when the upper chambers
of the heart contract in a rapid and/or disorganized way. Stroke, the
most serious consequence of AF, can develop as a result of blood clots
that form in the erratically contracting upper chamber of the heart.
AF increases the risk of stroke five fold and accounts for approximately
twenty percent of all strokes.
Anticoagulants are the current
standard -- and only proven -- therapy for the prevention of stroke
due to AF. Unfortunately, studies have shown that up to two-thirds AF
patients who are at risk of stroke can't or won't take anticoagulants,
usually the blood thinner known as warfarin.
"Chronic warfarin therapy
is known to reduce the risk of thromboembolic events among those with
AF and clinical risk factors but it is one of the most difficult medications
to administer in clinical practice," says Dr. Block, who recently performed
the first PLAATO procedures in Georgia and among the first in
the nation. He points out that frequent blood testing is required and,
in addition, warfarin is difficult to manage because of the large number
of drugs and foods that interact with the anticoagulant. Patients also
have up to a two percent risk a year for life threatening hemorrhages.
"The PLAATO procedure
represents a promising therapeutic alternative to a failed regimen of
medication and frequent blood monitoring. It has the potential to prevent
thromboembolic stroke in this high-risk population with a single catheter
intervention," says Dr. Block. "If the trials are successful, the device
could be an important interventional cardiology procedure."
Since 1975 Emory Crawford
Long Carlyle Fraser Heart Center has been recognized internationally
for its work in the diagnosis treatment and prevention of heart and
lung disease. The Carlyle Fraser Heart Center is part of the Emory Heart
Center, ranked in the top ten America's Best Hospitals by US News &
World Report. Emory Hospitals include Emory University Hospital, a 587-bed
hospital located on the Emory University campus in northeast Atlanta,
Crawford Long Hospital, Emory's 583-bed, community-based hospital in
midtown and Wesley Woods Geriatric Hospital, a100-bed hospital located
on the Emory campus. Emory Hospitals are components of EMORY HEALTHCARE,
the most comprehensive health care system in Atlanta. Other components
of EMORY HEALTHCARE are: The Emory Clinic, the Emory Children's Center,
the jointly owned Emory-Adventist Hospital, and EHCA, LLC, a limited
liability company created in collaboration with HCA Healthcare.