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M D N E W S . CO M ■ MD NEWS Long Island | 1 9 CO N T R O L LI N G R I S K FAC TO R S FO R S T R O K E ONE OF THE first lines of defense for preventing stroke is to control a patient's modifiable risk factors. According to the American Stroke Association, these include: + blood disorders, including sickle cell anemia + carotid artery disease or any other artery disease + diabetes + excessive alcohol consumption + heart disease or atrial fibrillation + high blood pressure — the leading cause of stroke + high cholesterol, which increases the risk of blocked arteries + illegal drug use + obesity or physical inactivity + tobacco use, which leads to damaged blood vessels + transient ischemic attacks, which are a major risk factor for stroke Other risk factors, such as increasing age, gender, heredity and race, cannot be modified. The American Heart Association stresses the importance of evaluating risk for both stroke and coronary events. Cardiovascular risk assessment tools that align with the accepted prevention guidelines are available for physician use. Individualized Care Drs. Brisma n a nd Pile-Spellma n consult with patients to assess risk and discuss the potential benefits of any treatment for carotid stenosis. They assess each case individually and work in tandem to deliver the best results for patients. Cardiology consultation is a crucial piece of the care process for patients at NSPC. "Each patient is evaluated for both procedures — we do not favor one intervention over the other, we provide the treatment that best addresses each patient's condition and risk factors," D r. Br ism a n notes. "B e c au se ou r expertise facilitates performing either intervention, we can look at each case objectively. Our low complication rates are a testament to our commitment to identifying the optimal procedure for every patient." Physicians begin by analyzing all appropriate imaging moda lities to identify the most effective treatment plan. They review all studies that may show complementary or confirmatory information. Angiograms, CT scans, MR Is a nd ultrasounds a re used to assist in the decision-making process for treatment and care. Ultimately, the course of treatment is a collaborative decision made after Drs. Brisman and Pile-Spellman meet w it h pat ient s to discuss t he r isk s and benefits of each procedure. Each surgical intervention is performed col- laboratively, so if complications arise, the collective expertise in the operating room facilitates smooth resolution. "Both of these procedures can be effi- cacious, but the team aspect enhances the surger y's success," Dr. Brisman says. "Dr. Pile-Spellman pioneered neuro-interventional procedures, and his expertise is an invaluable component to our team. We perform stents together because they're highly technical — our combined expertise helps ensure the success of our procedures." Learn more about Drs. Pile-Spellman and Brisman and the expert stroke care at NSPC by visiting nspc.com. ■ GIVEN ITS LONG history of safety and efficacy, carotid endarterectomy remains the first line of treatment for carotid stenosis. Carotid angioplasty and stenting may be an alternative for patients who are younger than 70 and who have particular conditions that would complicate endarterectomy. Members of the NSPC team