TransCarotid Artery Revascularization (TCAR) – Another option for stroke prevention
Oct. 4, 2019…A new procedure helps prevent strokes in patients at high risk for carotid endarterectomy and at high risk for standard carotid stenting.
It’s called TransCarotid Artery Revascularization, and DMH is one of only a few hospitals in Illinois to offer it.
This is a hybrid procedure that uses traditional surgical techniques to deliver a stent to the blocked carotid artery directly through a small incision in the neck.
“What makes it so cutting edge is that blood flow from the carotid artery to the brain is temporarily reversed and passes through an external filter before being re-entered into a vein in the groin,” says Vascular Surgeon Jeffrey D. Trachtenberg, MD, director of the DMH Vein and Vascular Institute. “This minimizes the risk of any dislodged plaque fragments from traveling to the brain and causing a debilitating or deadly stroke.”
That is why this new procedure has a lower stroke rate associated with it than traditional carotid surgery or carotid stenting alone, emphasizes Dr. Trachtenberg.
“TCAR is an important new tool in treating carotid artery disease for certain patients,” he says. “This technology will likely transform how we manage carotid disease in the future.”
Current guidelines restrict the use of TCAR to patients who meet certain criteria. These criteria place patients at higher risk for traditional surgery such as a pre-existing heart or other medical condition, previous surgery on the neck, radiation to the head or neck, obesity or advanced age. As the technology becomes more widespread, it is anticipated that TCAR will be available to patients who are lower risk as well.
TCAR patients also typically experience smaller incisions and scarring, spend less time in surgery and recovery, and most go home in less than 24 hours.