Medical Center is first hospital in the Sacramento region to perform 100th Transcarotid Artery Revascularization (TCAR) procedure
TCAR is a clinically proven, minimally invasive procedure to treat carotid artery disease and help prevent future strokes. 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.
“With up to a third of strokes caused by carotid artery disease, UC Davis Health offers patients minimally invasive options such as TCAR to prevent future strokes with a faster recovery time and an increased chance of being discharged to home,” said Misty D. Humphries, interim chief of vascular surgery. “TCAR is an important option in the fight against stroke and is available to all eligible patients, regardless of their surgical risk status.”
In 2019, UC Davis Health became one of the region’s first providers to offer the TCAR procedure. The following year, the UC Davis Vascular Center was named a TCAR Center of Excellence for the high quality of its care team and patient outcomes for TCAR procedures.
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 carotid endarterectomy (CEA), an open surgical procedure. CEA removes plaque from inside the carotid artery to restore normal blood flow to the brain, but the large incision leaves a visible scar the length of the neck. It also 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.
With up to a third of strokes caused by carotid artery disease, UC Davis Health offers patients minimally invasive options such as TCAR to prevent future strokes with a faster recovery time and an increased chance of being discharged to home.”
“While CEA is recognized as a safe, effective surgery, it’s still a fairly major surgery that typically takes a couple of hours and usually requires general anesthesia,” said Steven Maximus, assistant professor of vascular surgery, who performed the 100th TCAR procedure.
To protect patients from a stroke during the TCAR procedure, a tube inserted into the carotid artery is connected to a system that temporarily directs blood flow away from the brain – ensuring any dangerous debris that dislodges from the artery won’t reach the brain during the procedure. Any material is captured in a filter outside the body, and surgeons filter the blood before returning it to a vein in the groin. The stent is placed in the artery while the brain is protected during this temporary flow reversal. The entire procedure is performed in less than half the time of CEA – limiting the stress on the heart and reducing the risk of the patient having a stroke or heart attack. And since it’s less invasive, patients who undergo the TCAR procedure recover quickly and almost always go home the next day with less pain and smaller scars.
“TCAR is an important option in the fight against stroke because not only is it less invasive than CEA, but there is also less chance of heart attack and nerve injury,” added Maximus.
The TCAR® system 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. Over 40,000 TCAR procedures have been performed worldwide through clinical trial and commercial use. TCAR has been studied extensively, and the clinical data have been excellent.