TCAR – A New, Less-invasive Procedure For Patients At Risk Of A Stroke

Recently at The Surgical Clinic, we began offering a new procedure for our patients who showed signs of a stroke. Many have experienced the benefits of this less invasive carotid artery treatment. This breakthrough resulted in the TCAR procedure.

TCAR stands for Trans Carotid Artery Revascularization. Keep reading to learn more about this safe and effective operation.

Treating Carotid Arteries

Every year, more than 300,000 U.S. citizens suffer from some kind of blockage in their carotid arteries. Your carotid arteries are the major blood vessels that deliver blood to your brain. If left untreated, blood flow to the brain reduces or even stops, which can increase the risk factors of stroke.

The Surgical Clinic is pioneering the use of a breakthrough technology called Trans-Carotid Artery Revascularization (TCAR) to treat patients with carotid artery disease who are at risk for open surgery. The design of this modern, minimally invasive surgery removes the risk of stroke or brain damage during the procedure.

TCAR Procedure

Current treatment options like angioplasty and stenting come with limitations. For example, traditional treatment involves open surgery, or the use of carotid stents to clear the artery. A new technique called TransCarotid Artery Revascularization (TCAR) combines direct carotid artery access with robust blood flow reversal.

The blood flow reversal happens during ENROUTE Transcarotid Stent placement. During stent placement, the risk of plaque breaking off the vein walls and causing a dangerous blockages increases. A blood clot is another common type of material that can come loose during stent placement.

However, during TCAR, the device diverts the blood flow away from the brain, the debris will not pose a risk to the patient. These improvements allow for the neuroprotection of other procedures in a less invasive and more patient-friendly way.

How TCAR Works

The TCAR procedure is performed through a small incision at the neckline where there is direct access to the carotid artery. This incision is much smaller in comparison to a typical Carotid Endarterectomy (CEA) incision.

After the first incision, a flexible sheath is placed directly into the carotid artery. The sheath is then connected to a system that will reverse the flow of blood away from the brain. 

This is important because the reversed blood flow protects the patient’s brain from plaque that may come loose during the procedure. In contrast, if the blood flowed normally, that debris in the blood could cause a stroke during the procedure. Reversing blood flow away from the brain is not a problem when operating on a carotid artery, because the brain is fed many larger and smaller arteries.

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 CEA–limiting the stress on the heart and significantly cutting the risk of the patient having a stroke or heart attack during the procedure.

Diagnosing Carotid Arteries

If you are concerned about your carotid arteries, it is best to seek medical attention. When you go in for an examination, your doctor will listen for weakened blood flow in your artery.

Depending on the results, your doctor may recommend a magnetic resonance angiography (MRA) or a CT scan. In addition, an ultrasound may also be used to diagnose the strength of your blood flow.

Signs and Symptoms

Carotid artery disease has dangerous symptoms. For example, one symptom is a transient ischemic attack (TIA) which is often described as a mini-stroke.

While not as dangerous as other types of stroke, a TIA can affect several parts of your body. For instance, you may have trouble seeing or understanding speech. Patients also report feeling weakness that stays on one side of the body, as well as dizziness and headaches.

If you are not careful, your symptoms may not stop at an ischemic stroke. As more plaque builds up in the carotid artery, patients run even higher risks of a stroke. The symptoms of a stroke are the same as a TIA, however, a full stroke can leave more severe brain damage and other side effects.

How long does it take to recover from TCAR?

Patients who undergo the TCAR procedure typically recover quickly and in most cases may return to their daily routines the following day.

For more information about the TCAR procedure or to see if you may be a candidate, please contact one of our Vascular Surgeons at The Surgical Clinic. We have convenient locations throughout Middle Tennessee.


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