- Every year, 15 million people worldwide suffer a stroke.
- Nearly six million die and another five million are left permanently disabled.
- Stroke is the second leading cause of disability globally.
Ischemic strokes account for 80-90% of strokes and an estimated 20-30% of these are caused by disease in the carotid arteries which carry blood to the brain. If left untreated, these blockages can fragment, flow to the brain, and lead to a potentially disabling stroke, also known as a “brain attack.” If blood flow is stopped for longer than a few seconds, the brain cannot get blood and oxygen and brain cells can die, causing permanent damage.
Vascular disease in the carotid arteries of the neck
Vascular disease is caused by the build-up of fatty substances that collect and stick to the linings of your arteries, in a process known as atherosclerosis. You may also hear the terms “plaque”, “blockage”, “lesion”, or “stenosis”. As the plaque build-up continues, the internal lining of your artery thickens which causes the artery to narrow and limit blood flow to vital tissues and organs.
Some of the more commonly affected arteries are those located in the heart, legs, arms, neck, and kidneys. The symptoms from these blockages depend on what artery is affected and the severity of the blockage causing limited blood flow. The arteries in your neck, are called carotid arteries.
You should be screened for carotid artery stenosis if you have:
- Weakness, numbness, tingling or paralysis of the arm, leg, or face on one side of your body
- Trouble swallowing
- Loss of eyesight or blurry eyesight in one eye
- Dizziness, confusion, fainting, or coma
- Unexplained slurred or garbled speech
Sometimes, patients are screened for carotid artery stenosis if the doctor knows the patient has vascular disease elsewhere in the body. Blockages can also be found when your physician hears a sound through a stethoscope placed on the neck. The sound is caused by blood flowing past the blockage
What are the treatment options?
The most common treatment for severe carotid artery disease is a surgery called Carotid Endarterectomy (CEA), in which the surgeon makes an incision on your neck to access the affected artery, open the artery and remove the plaque. Your surgeon will then close the artery and the incision in your neck using stitches. For patients at high risk for the open surgical procedure, another option is transfemoral carotid angioplasty and stenting (TF-CAS). This minimally invasive alternative allows your physician to complete the procedure through a tube placed into the artery in your thigh.
A potential complication of both surgery and stenting is a stroke during the procedure itself. Studies have shown a higher risk of stroke during stenting as compared to surgery. The TCAR Procedure using the ENROUTE® Transcarotid Neuroprotection System is designed to reduce the risk of stroke while inserting the ENROUTE® Transcarotid Stent.
The TCAR Procedure: A less invasive and patient friendly option.
TCAR is a surgically inspired procedure and is designed to mimic the arterial access and safeguards of surgery. In carotid artery surgery, the arteries are clamped above and below the blockage to block blood flow and prevent plaque from traveling to the brain during treatment. Similarly, the ENROUTE® Transcarotid Neuroprotection System isolates the blockage from forward blood flow during stent placement by actually reversing blood flow away from the brain. Because the flow reversal method does not rely on a distally placed filter to capture emboli before they reach the brain, it collects both small and large debris.
What happens during the TCAR procedure?
The TCAR procedure is performed through a small incision at your neckline just above your clavicle. This incision is much smaller than a typical CEA incision. Our TCAR trained and certified surgeons will place a tube directly into your carotid artery and connect it to a system that will direct blood flow away from your brain, to protect against plaque that may come loose reaching your brain. Your blood will flow through the system and any material will be captured in a filter outside the body. Your filtered blood will then be returned through a second tube in your upper leg. After the stent is placed successfully, flow reversal is turned off and blood flow resumes in its normal direction.
What are some of the benefits of TCAR?
- minimally invasive
- faster recovery times
- reduced chance of complications vs. open surgery
For more information or to schedule an appointment, call 855-WVU-CARE (855-988-2273).