Stroke remains a major cause of mortality and chronic disability in the United States, affecting about 800,000 people a year. Around 20 percent to 30 percent of all strokes originate in the arterial blood vessels of the neck known as the carotid arteries. At the heart of carotid artery disease lies a process known as atherosclerosis. The condition develops slowly over time, generally because of elevated cholesterol levels, high blood pressure and smoking. These factors lead to hardening and narrowing of the arteries, which can increase the risk of stroke.
Carotid artery disease is generally addressed through two principal methods: Carotid artery endarterectomy (CEA) or carotid artery stenting (CAS). CEA is a surgical procedure under anesthesia involving a 5 cm to 6 cm incision in the neck over the affected artery. The artery is carefully exposed, opened, and the diseased interior of the vessel removed, restoring normal blood flow. In comparison, CAS is a minimally invasive procedure involving a needle access of the femoral artery in the groin. Both procedures have advantages and disadvantages.
Now, St. Clair Hospital surgeons Thomas Simone, M.D. and David Catalane, M.D. are utilizing a new surgical procedure for treating carotid artery disease. Transcarotid Arterial Revascularization (TCAR) offers a potentially safer method for carotid artery stenting. With TCAR, a small incision is made at the base of the neck above the collar bone. From this approach, the carotid artery is directly accessed, avoiding the blood vessels of the chest and decreasing the chance of stroke. Initial results with TCAR have been impressive, with the procedure having the lowest stroke rate of any previous stenting trial. The arrival of TCAR gives St. Clair a promising new therapy for vascular disease.