Our Approach

Your Health questions answered

Listen to Michael Jaff, DO, explain how knowing your personal and family history may help prevent a stroke

The Stroke and Carotid Artery Disease Program at the Massachusetts General Hospital Vascular Center uses innovative diagnostic, medical, surgical and endovascular interventions to treat carotid stenosis, the narrowing or blockage of the carotid arteries in the neck. Our clinicians also offer preventive care and advanced treatments for stroke, a common risk for people who have carotid stenosis.

A Multidisciplinary Approach to Vascular Care

The Mass General Vascular Center is one of the only vascular centers in the country with specialists in every area of vascular disease. Our Stroke and Carotid Artery Disease Program brings together a team of clinicians from multiple disciplines to provide care from many perspectives, including:

• Interventional imaging
• Neurology
• Neuroradiology
• Neurointerventional imaging
• Neurosurgery
• Vascular and endovascular surgery
• Vascular medicine and interventional cardiology

We work together with the patient and referring physician to coordinate personalized treatment plans for all patients.

Specialists Dedicated to Neurovascular Imaging

Our team of full time, board-certified imaging experts is made up of neurovascular radiologists, neurologists, vascular medicine and vascular surgery specialists who are specially trained to detect abnormalities in the vascular system and whose practice focuses specifically on vascular disease. Each specialist is trained in performance and interpretation of advanced neurovascular diagnostic tests.

Depending on the patient, we may use one or more diagnostic techniques, including:

• Duplex ultrasound
• CT scan
• Magnetic resonance angiography (MRA)

These tests are also available at our convenient Waltham location.

Preventing Stroke by Treating Carotid Stenosis

Our primary treatment goal is to prevent future stroke in patients through a combination of lifestyle changes, medical management and other interventions. Our neurovascular specialists guide patients through smoking cessation programs and work with cardiologists in the Heart Center to treat heart disease. We encourage our patients to make the following lifestyle changes, if necessary:

• Avoid smoking
• Control blood pressure
• Maintain normal blood sugar levels for those with diabetes
• Eat a diet low in cholesterol and saturated fats
• Exercise regularly
• Maintain a healthy weight
• Take platelet-blocking medications, such as aspirin

If our physicians decide to use an interventional approach, we offer the following procedures:

• Carotid endarterectomy. This surgical procedure removes plaque blocking or narrowing a patient’s carotid artery and has been shown to be an effective and safe way to prevent stroke caused by carotid stenosis
• Angioplasty and stenting. This newer, minimally invasive technique involves threading a balloon-tipped catheter through the affected artery to expand it. A stent may be inserted to keep the artery open. The physicians at the Stroke and Carotid Artery Disease Program are leaders in the use of angioplasty and stenting for carotid stenosis and are involved in national trials evaluating this technology

A State-Designated Primary Stroke Center

In 2006 Massachusetts General Hospital physicians treated more stroke patients with an in-hospital stay than any other hospital in Massachusetts. A state-designated primary stroke center, Mass General provides emergency diagnostic and therapeutic services 24 hours a day, seven days a week to patients with symptoms of acute stroke. Our Stroke Service focuses on the prevention, diagnosis and treatment of all stages of stroke.

These neurovascular specialists offer the following services to stroke patients:

• Preventive care and medical management of stroke risk factors
• Clot-dissolving medications (thrombolysis) and devices (thrombectomy)
• Surgical clipping or endovascular coiling of ruptured aneurysms (a cause of hemorrhagic stroke)
• Telestroke, which involves the use of videoconferencing and image sharing technology to diagnose and recommend treatments for patients at 12 community hospitals

About This Program The Stroke and Carotid Artery Disease Program at the Massachusetts General Hospital Vascular Center offers innovative diagnostic, medical, surgical and endovascular interventions to treat patients with carotid stenosis or stroke.

Internationally Recognized for Carotid Artery Disease and Stroke Treatment

The Vascular Center has a long tradition of excellence in clinical care, and our clinicians are internationally recognized as experts and innovators in the diagnosis and treatment of carotid artery disease and stroke. Our center incorporates renowned neurologists, surgeons, cardiologists and vascular medicine specialists who are leading figures in American cerebrovascular care.

Our collaborative, multidisciplinary team works together to bring state-of-the-art research and technology right to patients. Two of our physicians, including Kenneth Rosenfield, MD, and Richard Cambria, MD, are leading national research efforts to evaluate carotid endartectomy and carotid artery stenting to treat patients with carotid stenosis. All of our physicians are at the forefront of new research and serve on many national and international professional boards and societies.

Access to Promising New Treatments

The Vascular Center participates in most major clinical studies evaluating new technologies and medications to treat carotid stenosis. This allows us to bring our patients promising new treatments as quickly as possible. Some of these studies include:

• ACT 1. This innovative trial compares carotid endarterectomy with stenting in patients who have carotid stenosis but no symptoms. Dr. Rosenfield is the national principal investigator of the ACT 1 trial
• CREST. This trial looked at the efficacy of carotid endarterectomy versus stenting in patients with symptomatic carotid stenosis, and found that these two medical procedures are both equally safe and effective. These findings give physicians more options in tailoring treatments for their patients at risk for stroke

Patients interested in participating in clinical trials can browse online for open trials.

One Call Coordinates Care

Our dedicated nurse coordinator is available Monday through Friday from 8:00 am to 5:00 pm to take relevant information about your condition and symptoms and to make a timely appointment with the most appropriate specialist.

We strive to see patients as soon as possible and assign every patient one clinician to organize care between members of our multidisciplinary team. From diagnosis to treatment and follow-up, this physician guides patients through the treatment process.

Tracking Outcomes to Improve Care

The Vascular Center has taken the unprecedented step of independently following the outcomes of patients who have undergone procedures for carotid artery disease and stroke. While patients are in our care, we carefully document how they respond to treatment using the National Institutes of Health Stroke Scale.

We are one of the only hospitals in the nation to perform the Stroke Scale on patients scheduled for either carotid endarterectomy or carotid artery stent before and following their treatment. These tracking systems ensure we deliver quality care and inform the public about our success rates with unprecedented accuracy and objectivity.

Patients and families members can feel confident that our team is always striving to provide the best possible outcome.

Conditions and DiseasesThe care team at the Vascular Center encourages all patients and family members to learn more about conditions and diseases that affect the cardiovascular system. The links below provide more information about vascular conditions and diseases that might be treated within this program.

Carotid Artery Disease

Carotid artery disease, also called carotid artery stenosis, occurs when the carotid arteries, the main blood vessels that carry oxygenated blood to the brain, become narrowed.

Stroke

Stroke, also called brain attack, occurs when blood flow to the brain is disrupted.

Support and Wellness

Mass General is dedicated to ensuring that people understand their health care choices and have the necessary information to make decisions affecting their health and well being. The related support and wellness information listed below can play a role in treatment options.

Designing an Exercise Program

When you exercise, you'll breathe faster and more deeply. This maximizes the amount of oxygen in your blood.

Smoking and Cardiovascular Disease

Diseases caused by smoking kill more than 437,900 people in the United States each year. Around 35 percent of these deaths were cardiovascular related.

Determining Your Body Mass Index

A good indicator of how much fat you carry is the Body Mass Index (BMI). Although it is not a perfect measure, it gives a fairly accurate assessment of how much of your body is composed of fat.

The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.

An Eye-opener: What Screenings Can Do

Stents and surgery both safe for prevention of stroke, study says

Investigators from Massachusetts General Hospital revealed the results of the CREST trial, a study that looked at the efficacy of carotid endarterectomy versus stenting in patients with symptomatic carotid stenosis, and found that these two medical procedures are both equally safe and effective.

Vascular and Endovascular Surgery: Current Concepts and Techniques - 2009

This course is intended to provide an in‑depth examination of a spectrum of topics related to the management of patients with vascular disease.

Designing an Exercise Program

When you exercise, you'll breathe faster and more deeply. This maximizes the amount of oxygen in your blood.

Smoking and Cardiovascular Disease

Diseases caused by smoking kill more than 437,900 people in the United States each year. Around 35 percent of these deaths were cardiovascular related.

Determining Your Body Mass Index

A good indicator of how much fat you carry is the Body Mass Index (BMI). Although it is not a perfect measure, it gives a fairly accurate assessment of how much of your body is composed of fat.

Vascular Center

Phone: 877-644-8346
Hours: 9:00 am to 5:00 pm

Vascular Center at Waltham52 Second Avenue, Suite 2100
Waltham, MA 02451
Phone: 877-644-8346
Hours: 8:00 am to 5:00 pm
Learn about our convenient Waltham location