Northside Hospital Using Innovative TCAR Procedure to Treat Carotid Disease in High-Risk Patients to Reduce Stroke
Monday, February 11th, 2019
Northside Hospital Heart and Vascular Institute has been named a Center of Excellence for a minimally-invasive stenting procedure that effectively treats carotid artery disease in older and high risk patients. Northside is one of the first hospitals in the state of Georgia to receive this recognition, and offers the technology at its Atlanta, Cherokee and Forsyth locations.
The procedure, called Trans Carotid Artery Revascularization (TCAR), treats blockages in the carotid (neck) artery to reduce the risk of stroke, particularly in patients older than 75 years, and in patients at high risk for conventional open surgery.
Northside is among the first in Georgia participating in this procedure, which was approved by the U.S. Food and Drug Administration in 2015. Northside is one of the first facilities in Georgia to earn the distinction from Silk Road Medical.
Dr. Siddharth Patel, a general and vascular surgeon at Northside Hospital Heart and Vascular Institute, was the first physician to perform TCAR at Northside Hospital in 2016, shortly after it became available. He also teaches other vascular surgeons across the country on how to do the TCAR procedure.
Dr. Patel ranks in the top 10 for all physicians doing TCAR, with over 60 cases thus far.
“With a very efficient and minimally invasive procedure, we’re able to minimize the stress on older patients who are at high risk for stroke and heart attack,” said Dr. Siddharth Patel. “With TCAR surgery, we are temporarily reversing the flow of blood in the carotid artery, effectively preventing arterial plaque from embolizing to the brain and causing a stroke.”
In TCAR surgery the surgeon makes a small incision in the neck, below the blockage, and inserts a soft, flexible stent across the blockage under the protection of flow reversal; the procedure takes about 45 minutes. Most patients are able to go home soon after surgery, Dr. Patel said.
Prior to this new technology, the main treatment option for severe carotid artery disease was an open surgical procedure called carotid endarterectomy. This surgical technique allows for protection of the brain during the procedure, but the larger incision leaves a visible scar along 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.
“Patients who are 75 years or older, or have other comorbidities may have difficulty tolerating the stress of conventional surgery,” Dr. Patel said.
Dr. Patel recommends anyone with questions about the less-invasive TCAR surgery talk to their doctor.
About 795,000 people a year have strokes and more than 140,000 die, according to the CDC. Every year more than 400,000 people are diagnosed with blockages in their carotid artery that may lead to stroke.