Imagine having a blockage in one of your carotid arteries — the crucial blood vessels in your neck that supply oxygen-rich blood to your brain, face and neck. This plaque blockage puts you at an elevated risk for stroke, a serious condition that can strike suddenly and without warning.
Fortunately, a revolutionary minimally invasive procedure known as TCAR, or transcarotid artery revascularization, is now available. At HonorHealth, vascular and endovascular surgeons like Tiziano Tallarita, MD, perform this procedure to significantly reduce the risk of stroke associated with traditional treatments.
Often called the silent killer because it can happen quickly, stroke typically occurs without warning. Sometimes called a brain attack, a stroke causes a decrease in oxygen and blood flow to the brain. If you have high blood pressure, you may be at risk of stroke.
Here are some facts about strokes:
- Strokes cause disability and death.
- A stroke occurs every 40 seconds in the U.S.
- Women between the ages of 45 and 54 are twice as likely to have and die from a stroke as from breast cancer.
- Stroke is the fifth leading cause of death in the U.S.
- Stroke is the leading cause of disability.
Two kinds of strokes are common – ischemic and hemorrhagic:
- An ischemic stroke occurs when a clot blocks the blood traveling through a vessel in the neck or brain. A significant majority (87%) of strokes are ischemic.
- A hemorrhagic stroke is the result of a blood vessel that bursts or leaks in your brain.
In either case, brain cells deprived of oxygen die within minutes.
Restoring blood supply in the carotid artery
Before TCAR, doctors restored blood flow in the carotid artery using carotid endarterectomy (CEA) or stenting (CAS) through the groin.
“CEA has long been regarded as the gold standard for surgical treatment due to its low stroke risk,” notes Dr. Tallarita. “However, for high-risk patients – such as those with previous neck surgeries or radiation exposure – the risks of CEA can be higher.”
Transfemoral carotid artery stenting, while less invasive, also carries increased stroke risks due to the complexity of guiding a catheter through the femoral artery and across the blockage.
TCAR is minimally invasive
TCAR is a groundbreaking, minimally invasive approach that offers numerous advantages for suitable patients. With just a small incision above the collarbone, surgeons gain direct access to the blockage, minimizing trauma and recovery time.
During the TCAR procedure, a sheath is placed in the carotid artery and connected to another sheath in the femoral vein, reversing blood flow away from the brain. This unique technique prevents plaque and clots from reaching the brain, as a protective filter captures any harmful particles. Once the blockage is treated, normal blood flow is restored.
FDA-approved in 2016, TCAR is now beneficial for standard and high-risk patients with certain body types. The smaller incision leads to quicker recovery, minimal scarring and fewer complications overall. As Dr. Tallarita emphasizes, “We know that 15 to 16% of ischemic strokes are caused by blockages in the carotid artery. TCAR presents an exciting modern avenue for stroke prevention that leads to excellent results in selective patients.”
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