Transcarotid Artery Revascularization (TCAR)

Memorial Hermann is one of a small number of hospitals in the country offering transcarotid artery revascularization (TCAR), an innovative, minimally invasive treatment for patients at risk of stroke due to blockages in the neck arteries (carotid arteries). The TCAR procedure temporarily reverses blood flow in the artery while the surgeon places a stent in the artery, minimizing the risk of a stroke occurring during the stenting of the blocked artery.

TCAR is used to treat carotid artery disease. Fatty substances, known as plaque, can collect and stick to the linings of the arteries, ultimately narrowing the arteries, limiting blood flow to tissues and organs, a condition called stenosis. Stenosis of the carotid arteries – the arteries through which oxygen-rich blood flows from the heart to the brain – can result in stroke, the fifth leading cause of death and the leading cause of disability in the U.S.

To diagnose carotid artery disease, a doctor may perform one or more tests, including a carotid artery ultrasound or an angiogram. If the blockage is minor, surgical intervention may not be required. If severe blockage is detected, the patient may require surgery.

• Carotid endarterectomy (open surgery) – An open surgical procedure in which the surgeon exposes the carotid artery through an incision in the side of the neck, removes the plaque inside the artery and closes the incision.
• Transfemoral carotid stenting – Minimally invasive procedure in which the surgeon inserts a stent into the body through the femoral artery (large artery in the leg) and places the stent in the narrowed portion of the carotid artery. Clinical trials of transfemoral carotid stenting showed a twofold risk of stroke relative to carotid endarterectomy.
• Transcarotid artery revascularization (TCAR) – A less-invasive, clinically proven alternative to open surgery for patients with carotid artery disease who are at risk for open surgery due to age, other medical conditions or anatomic issues. The TCAR procedure is performed through a small incision at the neckline. Early in the procedure, the physician initiates temporary blood flow reversal in the artery, to protect the brain from stroke during placement of the stent.

The TCAR procedure is less invasive than traditional, open surgery, requiring shorter hospital stays and recovery time. Versus transfemoral stenting, TCAR poses less risk of stroke (during the procedure), since TCAR starts at the neck, not the groin. Bits of plaque and blood clots that could dislodge and otherwise travel to the brain and cause stroke are diverted away while a dedicated transcarotid stent is inserted to open and stabilize the blockage.

To learn more about treatment options, our cardiologists, or treatment facilities please use our contact form or schedule an appointment with a Memorial Hermann Cardiologist online »