Minimize the Risk of Stroke During Carotid Artery Surgery

Transcarotid Artery Revascularization (TCAR) is a minimally invasive surgical treatment for patients with carotid artery disease. While any repair of the carotid artery carries some risk of causing a stroke because of the repair itself, TCAR was designed to help minimize that risk by keeping potential stroke-causing fragments away from the brain.

Like the traditional open surgery, the TCAR procedure involves direct access to the carotid artery, but through a much smaller incision at the neckline just above the clavicle instead of a longer incision on the neck. During the TCAR procedure, a tube inserted into the carotid artery is connected to a system that temporarily directs blood flow away from the brain to protect against dangerous debris reaching the brain during the procedure. Surgeons then filter the blood before returning it to a vein in the groin, and a stent is implanted directly into the carotid artery to stabilize the plaque and prevent future strokes. The entire procedure is performed in less than half the time of traditional open carotid artery surgery limiting the stress on the heart and significantly cutting the risk of the patient having a stroke or heart attack during the procedure.

While there are several causes for stroke, it is estimated that up to a third of cases are caused by carotid artery disease – the buildup of plaque in one or both of the arteries in the neck that supply blood from your heart to your brain. When plaque builds up in the carotid arteries, they begin to narrow and blood flow slows down, potentially causing a stroke if blood flow stops or plaque fragments dislodge and travel up to the brain. Symptoms of a stroke include:

  • Blurred or loss of vision
  • Confusion
  • Loss of balance
  • Memory loss
  • Problems with speech and language, including loss of speech
  • Weakness in one part of your body

Patients who undergo the TCAR procedure recover quickly (typically spending just one night in the hospital) and almost always go home the next day to return to full and productive lives with less pain, smaller scars and a reduced risk of future strokes.

What is Carotid Stenosis?

Carotid stenosis, or carotid artery disease, is a narrowing or blockage of the carotid arteries. The carotid arteries are located on both sides of a person’s neck and carry blood and oxygen to the brain. Carotid arteries that are blocked or have become narrow can lead to decreased blood flow to the brain and a possible stroke. There are often no signs or symptoms of carotid artery disease and the presence of the disease is not known until a person has a stroke.

How TCAR Works

The TCAR procedure includes a small incision at the base of the neck where a stent is placed into the carotid artery. During the placement of the stent, blood flow through the carotid artery is temporarily reversed to help protect the brain from any debris that might become dislodged during placement of the stent. A small device is placed in the carotid artery that removes the blood and reroutes it to a vein in the leg via a circuit outside of the body.

That external device filters the blood to remove any plaque that may break free from the artery during the procedure. With TCAR, a stent is placed to open the artery, while protecting the brain from debris which that could result in a stroke.

Research has shown that temporarily reversing blood flow during the TCAR procedure is safe, and has been shown to reduce the risk of stroke as compared to traditional stenting or surgery.

Watch the videos to learn more about how the TCAR procedure works:

Individual results may vary. There are risks associated with any surgical procedure. Talk with your doctor about these risks to find out if TCAR is right for you.

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