Transcarotid Artery Revascularization (TCAR) is a minimally invasive procedure designed to treat Carotid Artery Disease by clearing blockages and opening a narrowed carotid artery, thereby reducing a patient’s risk of stroke. The carotid arteries are the main blood vessels that supply blood to the neck, face and brain. With Carotid Artery Disease, fatty deposits build up along the inner layer of the arteries and form plaque. This thickening narrows the arteries and decreases or blocks blood flow to the brain.
What is the difference between TCAR and a traditional Carotid Endarterectomy?
You may have heard of Carotid Endarterectomy, a traditional treatment for blockages in the carotid artery, and wonder what the difference is between it and TCAR. Carotid Endarterectomy is a more invasive surgical procedure in which a surgeon opens the carotid artery by making a long incision in the neck and removes the plaque.
With TCAR, there is less risk of nerve damage, as the procedure requires a much smaller incision. The surgeon works through the small incision to stabilize plaque from inside the artery and restore normal blood flow to the brain. The major difference is that TCAR uses advanced technology to reverse blood flow away from the brain during the procedure, thereby lessening the chance of a stroke. The patient will also spend far less time under anesthesia and will experience a faster recovery time.
What can I expect during the TCAR procedure?
You will be in a procedure room for your TCAR. After you are placed under anesthesia, your surgeon will make a small incision in your neck, just above your collarbone. A tube is then placed directly into your carotid artery and connected to an advanced system that temporarily reverses blood flow away from your brain. This is done to prevent any loose bits of plaque from reaching your brain and causing a stroke. Blood still reaches your brain through other blood vessels. Your blood is filtered by the system and returned to your body through a second tube connected to a vein in your groin. While the blood flow is reversed, a stent will be inserted into your carotid artery. Once the stent is in place, your surgeon will stop the blood flow reversal and your blood again flows toward your brain. Your surgeon will then close your incision.
Patients typically go home the day after their TCAR procedure, and should plan on taking it easy for a week or so. Your surgeon will discuss your recovery with you.
Am I a candidate for TCAR?
TCAR is a good option for patients who have a higher risk of surgical complications due to age or other health issues. Your surgeon will help you decide whether TCAR is right for you. You may be eligible if the following apply:
- Age 75 or Older
- Carotid Artery Disease
- Congestive Heart Failure
- Unstable Angina
- Heart Attack (Myocardial Infarction) within the past six weeks
- Severe Pulmonary Lung Disease
- Have undergone previous Neck Surgery
To see if TCAR is right for you, please speak to your physician.
Note: If you experience stroke-like symptoms, you should seek immediate medical attention and be evaluated for Carotid Artery Disease. Symptoms may include sudden loss of sight or speech, confused speech, weakness on one side of your face or body, and dizziness or fainting.