Patient of the Month

July, 2000

James Peterson

Jim is a 70 year old gentleman who underwent triple vessel coronary bypass surgery in 1996, and had a complete recovery. He has been walking three to four miles a day since then, and has enjoyed his life.

In 1998 he faced an entirely new challenge. In the course of a routine examination, Jane Magro, our nurse practitioner, detected an asymptomatic bruit in the left carotid artery, suggestive of an obstruction. A carotid ultrasound study demonstrated 85-90% blockage, and a cerebral angiogram confirmed this narrowing, but also revealed a larger aneurysm further inside the skull in an area not accessible to surgery. He was at high risk for stroke or death without correction of these problems.

He was referred to Dr. Vinuela at UCLA Medical Center in Los Angeles, and underwent a rare procedure which Dr. Vinuela has performed only 15 times before. This 8 ½ hour procedure involved placing a stent in the stenotic portion of the carotid artery, followed by a second stent inside the aneurysmal segment. Then tiny wire coils were passed through the second stent in order to fill in the aneurysm and prevent it from rupturing.

Now eight months later, Jim is feeling great, and has had no neurological symptoms or physical limitations. His successful outcome is a tribute to the quiet revolution in technology and medical skills which allow a person with hitherto inoperable cerebrovascular disease to have a successful nonsurgical procedure and excellent prognosis. Jim's remarkable story and his determination make him our Patient of the Month.

Jim is deeply indebted to Jane Magro for initially detecting his unusual problem.

Cerebral angiogram showing the large aneurysm at location A and severe stenosis of the carotid artery at location C.

The angiogram on the left is another closeup of the aneurysm at location A. The angiogram on the right shows closure of the aneurysm after intervention.

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