The carotid arteries on each side of the neck bring blood to the brain. The blood flow in the arteries can become partially or totally blocked by fatty material called plaque. Lack of blood flow to the brain can result in a stroke.
In 2004, the FDA approved the RX Acculink for patients with clogged carotid arteries who were at high risk of complications if they underwent a surgical treatment known as carotid endarterectomy, a procedure that involves cutting open the neck artery and scraping out the plaque.
Today’s action expands the indication for use of the stent to include all patients with clogged carotid arteries who are at risk for stroke, not just those who are not good candidates for surgery.
With the RX Acculink, physicians insert a catheter into the groin and thread it up to the affected neck artery. Physicians then place a small mesh tube, called a stent, into the artery to keep the artery open.
“Expanded access to RX Acculink means patients and their health care providers have another option for treating clogged neck arteries,” said Christy Foreman, M.B.E., director of the Office of Device Evaluation in the FDA’s Center for Devices and Radiological Health.
The FDA based its approval on a 10-year study of 2,502 patients at 119 clinical sites in the United States and Canada. Patients were treated and followed for at least one year. The National Institutes of Health helped to fund the study, which found that patients treated with RX Acculink had a similar combined rate of death, stroke, and heart attack (myocardial infarction) as those who underwent surgery.
An outside expert advisory panel convened by the FDA on Jan. 26, 2011, found the RX Acculink to be generally safe and effective for use in this new group of patients. But the panel emphasized the need for additional long-term follow-up information and the importance of the stent’s use in conjunction with an embolic protection device to capture plaque and other debris that break away during the procedure, potentially causing a stroke.
As a condition of the approval, the manufacturer, Abbott Vascular, is required to conduct a post-approval study, which will follow new patients treated with RX Acculink for at least three years to confirm the results identified in the pre-market study. The post-approval study will also evaluate how patients age 80 years and older respond to treatment, whether treatment success is affected by the physician’s experience with the product, and whether patients who show symptoms of having a clogged carotid artery experience a different outcome than those who don’t show any symptoms prior to treatment. The study is consistent with recommendations made by the expert advisory panel.
Abbott Vascular, a subsidiary of Abbott Laboratories, is located in Santa Clara, Calif.
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