In a first at an ambulatory surgery center, UB neurosurgeons placed a carotid artery stent and the patient was discharged the same day

BUFFALO, N.Y. – Each year, more than 100,000 patients who have experienced a stroke or a transient ischemic attack (TIA), also known as a “mini-stroke,” undergo a carotid artery stenting procedure to increase blood flow to their brain. That procedure is typically done in a hospital and usually involves an overnight stay.

But on Oct. 14, a team of University at Buffalo neurosurgeons performed what they say is a global first: They did the procedure on a patient at an ambulatory surgery center (ASC) specifically designed for neurosurgical procedures.

The patient was discharged the same day, marking a paradigm shift in how complex neurovascular interventions can safely be delivered.

“This was the first time a carotid stent was placed in a patient who underwent the procedure in an outpatient neurosurgery center — not in a hospital, not in a cardiac lab, but in a dedicated neurocenter built for precision, speed and safety,” says Elad Levy, MD, SUNY Distinguished Professor and L. Nelson Hopkins Endowed Chair of Neurosurgery in the Jacobs School of Medicine and Biomedical Sciences at UB.

“We’ve shown that the same precision used to protect the brain in hospital operating rooms can now be delivered safely in an outpatient environment,” he continues.

“This isn’t just a case; it’s a proof of concept that the future of vascular neurosurgery is outpatient.”

There are numerous advantages to moving patient procedures out of the hospital where possible: Outpatient care is more flexible and convenient, and results in significant cost savings. In addition, patients often recover more quickly when they are at home.

For all these reasons, Levy and his colleagues have been motivated to find innovative ways to shift some complex endovascular procedures from the hospital to the outpatient setting.

“We’ve re-engineered the environment, including imaging, anesthesia, workflow and recovery, to maximize safety, efficiency and neuro-precision in this setting,” says Levy. “Now, patients can receive lifesaving stroke-preventive vascular procedures in a same-day setting, with hospital-level precision in the hands of neurosurgeons who understand both the brain and the vessel.”

The team included Kenneth V. Snyder, MD, PhD, associate professor of neurosurgery, radiology and neurology, and Rosalind Lai, MD, assistant professor of neurosurgery, both of the Jacobs School and UBNS, along with residents Jaims Lims, MD, and Matthew Moser, MD.

The procedure took place at the Atlas Ambulatory Neurosurgery Center in Williamsville, N.Y., which is integrated with UB’s American Council on Graduate Medical Education-accredited neurosurgery residency training program.