Transcarotid Artery Revascularization

Transcarotid artery revascularization (TCAR) is an innovative, minimally invasive treatment that is safer and offers a faster recovery than carotid endarterectomy. With TCAR, cardiovascular surgeons use an advanced technique to open blocked arteries without the risk of plaque breaking loose during the procedure and traveling to the brain. Hackensack Meridian Health Jersey Shore University Medical Center and Hackensack University Medical Center are two of only three hospitals in the state to offer this leading-edge procedure. In fact, our cardiovascular specialists are among a small number of physicians in the country who are experienced in TCAR.

Carotid artery disease happens when the arteries on the side of the neck are narrowed by a fatty substance called plaque. If a blood clot gets trapped in the artery or a piece of plaque breaks off and travels to the brain, it can cause a life-threating stroke.

The traditional approach to treating carotid artery disease is an open procedure called carotid endarterectomy. Transcarotid artery revascularization (TCAR) is an innovative, minimally invasive treatment that is safer and offers a faster recovery. With TCAR, cardiovascular surgeons use an advanced technique to open blocked arteries without the risk of plaque breaking loose during the procedure and traveling to the brain.

Hackensack Meridian Health Jersey Shore University Medical Center and Hackensack University Medical Center are two of only three hospitals in the state to offer this leading-edge procedure. In fact, our cardiovascular specialists are among a small number of physicians in the country who are experienced in TCAR.

As a leader in cardiovascular treatment, we offer innovative approaches that aren’t available anywhere else nearby. Our integrated health network includes community hospitals throughout New Jersey that provide advanced cardiovascular testing, cardiac rehabilitation and follow-up services for complete care that’s close to home.

Who Is a Candidate for Transcarotid Artery Revascularization?

Transcarotid artery revascularization can help minimize stroke risk in people with carotid artery disease, particularly those who aren’t able to have open surgery because they:

• Are obese
• Have undergone previous surgery on their neck
• Have a pre-existing heart condition
• Have had radiation to their head or neck

What to Expect During TCAR

Patients are given medicine to relax, and the areas where incisions are made are numbed. The surgeon makes a small incision just above the collarbone and places a small, hollow tube called a catheter into the carotid artery. The catheter is connected to a filtering system that directs blood away from the brain and through the filtering system:

• Any solid materials are captured in a filter outside the body.
• Filtered blood is returned through a second catheter inserted through a puncture in the upper leg.

With blood flow directed away from the brain, balloon angioplasty can be performed safely. The surgeon uses advanced imaging to guide the catheter with a balloon on the tip the blocked area of the carotid artery.

Once in place, the balloon is inflated, which presses the plaque against the artery wall, and a wire mesh tube called a stent is inserted into the artery to stabilize the plaque. Once the stent is in place, the filtering system is stopped and normal blood flow resumes.

Most patients go home within 24 hours of the procedure.