Dr. Wayne Olan, an Interventional Neuroradiologist and Director of Minimally Invasive Neurosurgery at George Washington University, shares invaluable insights. He discusses the historical evolution of carotid artery stenting and how modern techniques have transformed the field. Dr. Olan highlights the importance of meticulous planning and the role of antiplatelet therapy, especially for Plavix non-responders. He also explores innovations like the Contego stent system and the future of outpatient carotid stenting, emphasizing the need for continuous adaptation in medical practices.
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Career Path Shaped By Cross-Training
Wayne Olan describes joining neurosurgery at George Washington and training residents in stroke and carotid interventions.
He credits that training for preparing fellows to be valuable in diverse practices.
insights INSIGHT
Stroke Care Is High-Value And In Demand
Stroke intervention demand has surged because it dramatically improves long-term outcomes and reduces costs.
Wayne Olan calls stroke work one of the most emotionally rewarding and high-impact parts of his practice.
insights INSIGHT
Stenting Emerged From Practical Need
Carotid stenting evolved from necessity for high-risk surgical patients and early innovators improvised extensively.
Olan notes modern devices simplify procedures but clinicians still need skill and judgment.
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From new techniques to evolving best practices–are you up to date with the latest developments in carotid artery stenting? In this episode, Dr. Wayne Olan, Interventional Neuroradiologist and the director of Minimally Invasive Neurosurgery at George Washington University joins Dr. Michael Barraza for a discussion on the latest innovations and evolving techniques in carotid artery stenting.
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SYNPOSIS
Dr. Olan opens the conversation with a historical perspective on the evolution of carotid stenting, tracing advancements from early techniques to modern devices. He then talks through referral patterns, noting that the majority originate from cardiologists. Dr. Olan emphasizes the importance of meticulous periprocedural planning and comprehensive post-procedural management. Central to this discussion is the critical role of antiplatelet therapy, including strategies for addressing Plavix non-responders, such as the use of Integrilin.
The discussions also covers advanced techniques in carotid artery stenting, including the utilization of the Aptus sheath and the Contego stent system. He underscores the importance of mastering the available tools, understanding patient-specific factors, meticulous procedural planning, and always maintaining a contingency plan. He concludes the discussion by exploring emerging trends and the future potential of outpatient carotid stenting.
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TIMESTAMPS
00:00 - Introduction 02:44 - The Importance of Stroke Intervention 07:16 - Carotid Stenting: Evolution and Techniques 13:29 - Challenges and Collaborations in Carotid Interventions 16:17 - Technical Insights and Best Practices 25:24 - Choosing the Right Wire for Carotid Procedures 25:53 - Anticoagulation and Filter Wire Techniques 28:30 - Managing Stent Placement and Distal Protection 30:54 - Handling Carotid Bifurcation and Skull Base Lesions 38:43 Dealing with Tandem Occlusions 42:06 - Future Trends in Outpatient Procedures 44:43 - Addressing Re-stenosis and Vertebral Lesions 45:44 - Conclusion and Final Thoughts
BackTable Vascular & Interventional