Carotid artery disease is a form of atherosclerosis, or a buildup of plaque, in the two main arteries in the neck that supply oxygen-rich blood to the brain. If left untreated, carotid artery disease can often lead to stroke; it is estimated to be the source of stroke in up to a third of cases, with 427,000 new diagnoses of the disease made every year in the U.S. alone.
“Patients who fall into a high-risk category should not have to choose between treatment and quality of life. TCAR offers a safe, effective alternative to traditional treatments for carotid artery disease,” says Alexander Uribe, MD, Chief of Vascular Surgery at Main Line Health. “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.” The Lankenau Heart Institute team of vascular specialists who use minimally invasive approaches such as TCAR and provide a full range of vascular care include Henry Hirsch, MD, Robert Meisner, MD, and Vincent DiGiovanni, DO.
TCAR is unique in that blood flow is temporarily reversed during the procedure so that any small bits of plaque that may break off are diverted away from the brain, preventing a stroke from happening. A stent is then placed inside the artery to stabilize the plaque, minimizing the risk of a future stroke.
Prior to TCAR, the main treatment option for severe carotid artery disease was an open surgical procedure called carotid endarterectomy (CEA). Unlike TCAR, CEA requires a large incision, leaves a visible scar the length of the neck and carries risks of surgical complications, including bleeding, infection, heart attack and cranial nerve injuries that can cause issues with swallowing, speaking and sensation in the face.
The TCAR procedure was developed by Sunnyvale, California-based Silk Road Medical, Inc. and includes the ENROUTE® Transcarotid Neuroprotection (NPS) and Stent System – the first devices designed and FDA-approved specifically for TCAR. TCAR has been studied extensively and is an FDA-cleared procedure. Over 25,000 procedures have been performed worldwide, and the clinical data have been excellent. Based on published clinical trials, the procedure offers several advantages, including better outcomes and a quicker recovery.
About Lankenau Heart Institute
The Lankenau Heart Institute is Main Line Health's premier, comprehensive cardiovascular medicine and surgery program. Lankenau Heart Institute brings together the clinical expertise of all four Main Line Health acute care hospitals and community cardiology practices to ensure that patients receive a level of quality, service, and experience that is unprecedented in the region. Through the system-wide coordination of services, Lankenau Heart Institute delivers preventive, diagnostic, therapeutic, and rehabilitative cardiovascular services at each of our locations including Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital.
Lankenau Heart Institute continues to be an innovator in the use of beating-heart techniques and robotic-assisted procedures for coronary artery revascularization, minimally invasive and transcatheter approaches for valve repair and replacement, complex aortic surgery and heart rhythm disorders. With our growing experience and focus on minimally invasive techniques, Lankenau Heart Institute has expanded participation in clinical trials year over year. Our physicians are frequently invited to participate in clinical/medical device trials, many of these designed to facilitate and expand the use of minimally invasive approaches and procedures.
With a collaborative team of expert consultative cardiologists, interventional cardiologists, electrophysiologists, cardiovascular surgeons and specially trained advance practice nurses and technologists, Lankenau Heart Institute is dedicated to managing and treating patients with simple to complex cardiovascular disease, including heart failure, aortic disease, coronary and peripheral vascular disease, heart rhythm disorders and valve disease. Our team of cardiologists and cardiac specialists provide patients and their families with expert cardiac care, close to home.
About Lankenau Medical Center
Lankenau Medical Center, a member of Main Line Health, has been devoted to the health and well-being of the community since 1860, with a founding mission to serve all those in need. Our continued dedication to service, compassionate patient care and superior clinical programs makes Lankenau a preferred destination for care by people throughout the Philadelphia region and beyond. Lankenau offers primary care, disease prevention and specialized medical and surgical management of all diseases and disorders, as well as access to clinical trials. As a 371-bed teaching and research hospital, Lankenau is committed to maintaining high-level expertise across all clinical areas and is consistently recognized for providing outstanding care. Lankenau is ranked in U.S. News & World Report's Best Hospitals 2022–23 in the top three in the Philadelphia region, top six in Pennsylvania and top 50 in the nation for obstetrics and gynecology. Lankenau is rated as high performing in the following specialties: Cardiology & Heart Surgery, Orthopedics, Pulmonology & Lung Surgery, Urology. Lankenau is rated as high-performing in the following procedures and conditions: Aortic Valve Surgery, Back Surgery (spinal fusion), Chronic Obstructive Pulmonary Disease (COPD), Colon Cancer Surgery, Diabetes, Heart Attack, Heart Bypass Surgery, Heart Failure, Hip Fracture, Hip Replacement, Knee Replacement, Kidney Failure, Lung Cancer Surgery, Pneumonia, Transcatheter Aortic Valve Replacement (TAVR). Lankenau has achieved The Joint Commission's Gold Seal of Approval for stroke care and breast cancer care and is one of the nation's Top Performing Hospitals for heart attack, heart failure, pneumonia and surgical care. Lankenau Medical Center was rated a top performer in the Centers for Medicare & Medicaid Services' (CMS) Overall Hospital Quality Star Rating. Lankenau has also earned the highest distinction for excellence in nursing care, the American Nurses Credentialing Center Magnet® designation.
About Main Line Health
Founded in 1985, Main Line Health is a not-for-profit health system serving Philadelphia and its western suburbs. Main Line Health's commitment—to deliver advanced medicine for treating and curing disease, playing an important role in prevention and disease management as well as training physicians and other health care providers—reflects our intent to be the region's premier choice for clinical care, research, and education. A team of nearly 13,000 employees and more than 2,000 physicians care for patients throughout the Main Line Health System.
At Main Line Health's core are four of the region's most respected acute care hospitals—Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital—as well as one of the nation's premier facilities for rehabilitative medicine, Bryn Mawr Rehabilitation Hospital.
Main Line Health also includes Mirmont Treatment Center for drug and alcohol recovery; Main Line Health HomeCare & Hospice, which includes skilled home health care, hospice and home infusion services; Main Line Health Centers, primary and specialty care, lab and radiology, and other outpatient services located in Broomall, Collegeville, Concordville, Exton, King of Prussia and Newtown Square; Lankenau Institute for Medical Research, a biomedical research organization; and Main Line HealthCare, one of the region's largest multispecialty physician networks.
Main Line Health is the recipient of numerous awards for quality care, and service, including U.S. News & World Report's Best Hospitals, System Magnet® designation; the nation's highest distinction for nursing excellence and the Mid-Atlantic Alliance for Performance Excellence (MAAPE) Excellence Award. Main Line Health is committed to creating an environment of diversity, respect, equity, and inclusion, has proudly received awards in this area and has embraced the American Hospital Association's #123forEquity Pledge to Act to eliminate disparities in care. We are dedicated to advancing patient-centered care, education, and research to help patients stay healthy and live their best lives.