Craig VanDerVeer, M.D., and patient Ronnie Presnell
Pioneering Procedure Used
To Treat Aneurysm In Cartoid Artery
Originally published Fall 1999

Mecklenburg County Sheriff’s deputy Ronnie Presnell now has a lower risk of stroke thanks to a stent implanted by neurosurgeon Craig VanDerVeer, M.D., of Carolina Neurosurgery & Spine Associates. A stent, which is usually used in combination with balloon angioplasty to open blocked arteries in the heart, was used to treat an aneurysm in Presnell’s carotid artery.

“To the best of our knowledge, this exact procedure has never been performed before in the brain,” said Dr. VanDerVeer, who along with radiologist Tony Bell, M.D., determined that there was no other way to treat Presnell’s aneurysm due to its location.

The aneurysm was the result of a traffic accident which left Presnell in a coma for 5 1/2 weeks. He suffered a ruptured spleen, five broken ribs, a broken leg, broken jaws and cheeks, a broken nose, and was also left blind due to damage to his optic nerve. “Dr. Scott McLanahan (of Carolina Neurosurgery & Spine Associates), and the trauma team saved Mr. Presnell’s life after the accident,” said Dr. VanDerVeer. “However, he had a skull-based aneurysm which still threatened his life.” Because of its location, the aneurysm, which was about the size of a quarter, could not be treated with conventional methods.

“I knew that a stent could be used to span the damaged vessel. The strategy was to then employ a vein graft to wrap the stent, providing a natural membrane to “sandwich” between the stent and damaged vessel,” Dr. VanDerVeer explained.

Photo taken from footage of actual stent used to repair
Mr. Presnell’s damaged artery.
For the graft, a vessel from the leg was chosen because of its naturally muscular wall. “The vein graft was harvested, microscopically sutured to an expandable wall stent over a balloon, and deployed by Dr. Bell,” said Dr. VanDerVeer. “It worked beautifully and Mr. Presnell’s postoperative and three month follow up angiogram looked perfect. The procedure preserved his vitally important carotid artery, preventing rupture of the artery and protecting his brain from stroke.”

“It’s cases like this one that reaffirm the reasons I became a doctor,” said Dr. VanDerVeer. “The ability to help a patient avoid a life threatening situation, along with the teamwork and problem solving required for this case made it all very satisfying.”

Dr. VanDerVeer and Dr. Bell plan to submit an article about this case to a neurosurgery journal so that this minimally invasive procedure can benefit other patients around the country. For more information, contact Carolina Neurosurgery & Spine Associates at 1-800-344-6716
or click here.

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