August 9, 2023

Revolutionizing Stroke Prevention: Elliot Hospital's Minimally Invasive TCAR Procedure


Minimally Invasive Procedure Treats Carotid Artery Disease


Elliot Health System announces an innovative technique that is offered to patients to treat carotid artery disease and prevent future strokes. The procedure is called Transcarotid Artery Revascularization (TCAR). TCAR is a clinically proven and minimally invasive approach for high surgical risk patients who need carotid artery treatment.

May is National Stroke Awareness Month—a time to underscore the effects of carotid artery disease, which is a form of atherosclerosis, or a build-up 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.

According to the Centers for Disease Control and Prevention, every 40 seconds, someone in the United States has a stroke. The Elliot offers patients minimally invasive options such as TCAR to prevent future strokes.

“We are pleased to offer this procedure to certain patients if they need to be treated for carotid artery disease. It is less invasive than traditional carotid artery surgery, and there is less risk of complication than with traditional surgery,” said Chelsey Lewis, MD, RPVI, American Board-Certified Vascular Surgeon at The Elliot. “During National Stroke Awareness Month, we want to share information about TCAR, as we have had many successful patient outcomes from this procedure.”

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. 

The Vascular Surgery team, led by Dr. Chelsey Lewis and supported by Vascular Service Line Specialty Coordinator Kathleen Pavesi, RN, Ernie Buonopane Lead Surgical Technician, and Leniol Jeudy, Interventional Radiologist Lead Technician, among others, successfully utilize this new technique to reduce stroke risk during a carotid stent procedure.

Prior to TCAR, the main treatment option for severe carotid artery disease was an open surgical procedure called carotid endarterectomy (CEA). CEA removes plaque from inside the carotid artery, but the large incision can leave a visible scar the length of the neck and carries increased 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.  It is important to note that these risks are low with either procedure and CEA remains and effective treatment for patients who are not candidates for TCAR.

The TCAR procedure was developed by Sunnyvale, California-based Silk Road Medical, Inc. and includes the ENROUTE® Transcarotid Neuroprotection (N.P.S.) and Stent System – the first devices designed and FDA-approved specifically for TCAR. More than 35,000 TCAR procedures have been performed worldwide through clinical trial and commercial use. TCAR has been studied extensively, and the clinical data have been excellent. Additional information about TCAR is available here.

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