The TCAR (transcarotid arterial revascularization) procedure involves a small incision above the collarbone, where a sheath is placed in the carotid artery. Blood flow is temporarily reversed to protect the brain, and a carotid stent is delivered and implanted in the carotid artery to stabilize the plaque and protect patients from future strokes. Once the intervention is complete, blood flow is restored.
TCAR is an alternative treatment option for carotid artery disease which involves an open surgery known as carotid endarterectomy (CEA). CEA has proven effective in preventing stroke, but carries the risks of surgical complications like myocardial infarction (heart attack) and injury to nerves that are near the surgical incision. The FDA-cleared TCAR procedure adopted many of the surgical principles of CEA, but uses less invasive tools such as carotid stents and guide wires in order to avoid those surgical complications, making it a better choice for high-risk patients.
Typically, when cardiologists attempt to treat carotid disease, there is some risk of causing a stroke due to plaque and blood clots breaking off and flowing to the brain during the procedure. The TCAR procedure involves placement of a stent in the blocked artery and creating a protective, temporary reversal of blood flow and plaque away from the brain, and has been clinically proven to reduce the risk of stroke and reduce the risks of complications from traditional surgery.
Vascular surgeons at New Mexico Heart Institute are within a select group of experts in clinical research that were asked to participate in this study that is transforming the treatment for carotid disease. New Mexico Heart Institute started conducting the new procedure in October 2016 with overall outcomes that are as good as traditional open stroke-prevention surgery. In addition to less risk of stroke, benefits to the patient also include a lower risk of heart attack, less time under anesthesia, an easier recovery and a shorter hospital stay.
Here is a video describing the TCAR procedure: TCAR procedure video