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Carotid Stenting Program |
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Recently, the FDA approved two commercially available stents to be used to treat carotid artery stenosis. At University of Colorado Hospital, there has been an Interventional Radiology program in neuro-interventions, including carotid stenting with distal protection in non-surgical candidates that is led by Dr. David Kumpe. In the last few months, a multidisciplinary group has developed credentialing standards for a multi-departmental program in the diagnosis and treatment of carotid artery disease. The program now includes to Interventional Radiology, Interventional Cardiology, Vascular Surgery and Neurology. The goal is to become a major referral center for the Rocky Mountain region in carotid artery stenting and to develop a companion academic program.
In August 2004 a joint subcommittee of University of Colorado Hospital Credentialing finished agreement on requirements for privileges to perform carotid stenting. With representatives from Interventional Radiology (Johnson), Cardiology (Carroll), Vascular Medicine (Hiatt), Cardiac Surgery (Fullerton) and Vascular Surgery (Whitehill) agreement was reached on terms and administration of credentialing in this area that is often a very contentious battleground for these specialties.
The Carotid Clinical Program is being planned by members of Interventional Radiology (Kumpe-Johnson), Cardiology (Messenger and Casserly), Vascular Surgery (Whitehill), Neurology (Al Anderson), Vascular Medicine (William Hiatt) and the Cardiac and Vascular Center .
Medical Simulation Corporation, a local company with UCD partnerships in several areas, has become a national leader in utilizing simulation technology for training in carotid interventions. A UCD simulation and advanced training center is under discussion, lead by John Messenger from Cardiology.
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Patients who should be referred to the Carotid Clinical Program at University of Colorado Hospital include: 1) Patients who have symptoms (TIAs, prior stroke) from cervical carotid or vertebral artery atherosclerosis who are not good candidates for carotid endarterectomy or who wish to avoid surgery. Patients who are not good surgical candidates include those with contralateral carotid occlusion, history of neck irradiation, a high carotid bifurcation (behind the mandible), tight recurrent stenosis following carotid endarterectomy, and significant medical comorbidities. 2) Patients with tight asymptomatic stenoses (>80%) with the same criteria as above. 3) Patients with symptomatic intracranial stenoses in the distribution of either the carotid or vertebral circulation.
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Dr. Kumpe is chief of Interventional Neuroradiology at the University of Colorado Denver. He is involved in the treatment of cerebral aneurysms and vascular malformations of the brain in addition to the treatment of carotid and vertebral artery stenoses in the neck. In addition, Dr. Kumpe is involved with treatment of intracranial stenoses and dissections of the cervical and intracranial arteries.
Dr. Stephen Johnson is chief of Interventional Radiology. The interventional service coordinates noninvasive carotid imaging and performs the large majority of diagnostic cerebral angiograph.
Dr. Messenger has been scrubbing with Dr. Kumpe for carotid artery stenting cases providing expertise in distal protection devices.
Ivan Casserly, M.D., joined the Interventional Cardiology group in November 2004 with a primary appoint at the DVAM. Dr. Casserly has completed extensive cardiac, peripheral, and carotid interventional training at the Cleveland Clinic and Washington University. He is critical in developing the academic program at University of Colorado Denver (UCD) and a clinical program at DVAMC.
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David Kumpe, MD
Director, Carotid Stenting Program
Professor of Radiology
Stephen Johnson, MD
Professor of Radiology
John Messenger, MD
Associate Professor of Medicine
Ivan Casserly, MD
Assistant Professor of Medicine
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