Carotid artery disease occurs when the carotid arteries in your neck get blocked by a substance called plaque. Over time, the plaque can cause the artery to narrow, putting you at risk for a stroke. In fact, one-third of strokes originate in the carotid arteries.
If you have this disease, your doctor may recommend having surgery to remove the plaque. For patients who are at high risk for surgery, due to age or other medical conditions, Lankenau Heart Institute offers a new, less invasive treatment for carotid artery disease, called transcarotid artery revascularization (TCAR).
Benefits of TCAR
"There are positive benefits to patients who get treatment for carotid artery disease, including a reduced risk for stroke," says Alex Uribe, MD, chief of vascular surgery at Lankenau Heart Institute, part of Main Line Health.
"The minimally invasive TCAR procedure allows us to place stents in high-risk patients, and they recover more quickly with less pain," says Dr. Uribe. "This includes older patients, those who have had previous surgery or radiation treatment, or those with other diseases that make open surgery risky."
TCAR patient success story
Louise Craig, age 84, is a perfect example. She had the TCAR procedure in June 2020 after she had been diagnosed with carotid artery disease a few years before. "My doctor recommended a catheter procedure, but it didn't work because they couldn't reach the blockage," she says. But when she switched doctors last year, her new doctor recommended she try again. He referred her to Robert Meisner, MD, a vascular surgeon at Lankenau Heart Institute and a colleague of Dr. Uribe.
"Dr. Meisner said my condition was pretty serious and recommended I try TCAR this time," says Louise. "While it is a new procedure, Dr. Meisner reassured me it was safe and the best option for my condition. It seemed pretty straightforward, so I decided to do it." She says everything went well, and she's now feeling great and can't even see the small scar.
How TCAR works
TCAR is done with a small incision just above the collarbone. During the procedure, a small tube or catheter is inserted into the carotid artery and is attached to a filtering system that directs blood flow away from the brain. This protects against any debris from the procedure reaching the brain and causing a stroke.
A stent is placed directly into the carotid artery to keep the plaque from moving, preventing future strokes. "The procedure takes about 45 minutes and is performed under local anesthesia. Most patients go home the next day with limited restrictions on their activities," says Dr. Meisner.
"I would absolutely recommend TCAR to anyone who needs this surgery," Louise says. "There were no stitches involved, and I just spent one night in the hospital. I came through everything fine."
"To be among the first in our region to offer this treatment as an option for high-risk patients is another testament to Main Line Health's reputation for excellent stroke care and intervention," says Dr. Uribe.