Learn how a new vascular procedure reduces stroke risk
For years, treatment for carotid artery disease has revolved around two types of procedures: surgery to remove the plaque buildup or a stent placement in the artery to improve blood flow to the brain.
A cutting-edge procedure called transcarotid artery revascularization (TCAR) is designed to now offer the best of both techniques by reducing the risk of surgical complications and preventing serious side effects – most notably, stroke.
Carotid artery disease occurs when fatty deposits clog the major blood vessels in the neck that supply blood to the brain. Risk factors include smoking, diabetes, hypertension and high cholesterol, among other causes.
“The problem with these blockages is they can cause a stroke if they get to be too severe,” says Dr. Chad Jacobs, a vascular surgeon at Advocate Lutheran General Hospital in Park Ridge, Ill. “They can close off the artery completely, or pieces of the plaque can break off and travel up to the brain, causing an ischemic stroke.”
Many patients with carotid artery disease undergo an endarterectomy, a surgical procedure requiring an incision along the neck to expose the artery and clear out the debris, Dr. Jacobs says.
Stenting, which uses a small metal-mesh device to reopen the artery, is a less invasive and increasingly popular option. But the stroke risk remains prevalent, as plaque could still get caught in the bloodstream and make its way to the brain, he says.
“Both procedures, while effective, have their disadvantages,” Dr. Jacobs says. “The TCAR technique uses a hybrid approach to prevent strokes, reduce recovery time and ultimately give better results.”
During the minimally invasive procedure, a sheath is used to temporarily reverse the direction of the blood flow while a stent is placed in the carotid artery, says Dr. Jacobs, who performed Advocate Lutheran General’s first TCAR in September. Any loose plaque is diverted from the brain, travels through the sheath tubing and is caught in a filter outside the body, he says. The blood flow resumes its normal direction after the stent is stabilized.
The TCAR technique still requires anesthesia and a small incision at the base of the neck, though it’s less risky than a carotid endarterectomy, Dr. Jacobs says. And while patients typically need to be hospitalized overnight, the overall recovery and return to normal activity is much faster.
“For many patients, this certainly is an effective and safer way of treating carotid artery disease,” Dr. Jacobs says.
The World Stroke Organization estimates one in four adults over the age of 25 will experience a stroke in their lifetime. If you suspect someone is having a stroke, act immediately and call 911.
Remember the B.E. F.A.S.T warning signs:
Balance: Is the person experiencing loss of coordination?
Eyes: Is the person having trouble seeing?
Face: Ask the person to smile. Does one side of their face droop?
Arms: Ask them to raise their arms. Does one drift downward?
Speech: Is their speech slurred or strange?
Terrible headache and Time to call 911: Does the person have a terrible pain that feels like “the worst headache ever?”
Want to learn more about your risk for stroke? Take a free online quiz here.
About the Author
Lauren Rohr is a public affairs coordinator with Advocate Aurora Health. She studied journalism at the University of Illinois at Urbana-Champaign and spent the last several years working as a news reporter covering public health, local government, politics, education and all facets of life in the Chicago suburbs. In her free time, she enjoys reading, baking, staying active and cheering on her favorite sports teams, especially the Chicago Blackhawks and the Fighting Illini.