Understanding the most common surgeries can help prepare patients for potential procedures. Knowing...
Read MoreCarotid artery disease is a serious condition that can increase the risk of stroke. Fortunately, several treatment options are available to help restore proper blood flow and reduce that risk.
Two of the most common treatments for carotid artery disease are transcarotid artery revascularization (TCAR) and traditional treatments like carotid endarterectomy (CEA) and carotid artery stenting (CAS). How do these options compare, and which one is right for you? Let’s break it down.
What is TCAR, and how does it work?
TCAR is a minimally invasive procedure to treat carotid artery disease and prevent stroke. “Unlike traditional carotid artery surgery, TCAR uses a small incision at the base of the neck to access the carotid artery,” said Andre Cole, D.O., is a vascular surgeon at Inspira Surgical and Vascular Center in Vineland. “A specialized system temporarily reverses blood flow during the procedure, preventing plaque from traveling to the brain.” A stent is then placed to keep the artery open and improve blood flow.
How does TCAR compare to traditional treatments like CEA?
Carotid endarterectomy (CEA) is the standard surgical approach to treating carotid artery disease. During the procedure, your specialist makes an incision along the neck to remove plaque from the artery. While highly effective, CEA is more invasive than TCAR and may carry a higher risk of complications, especially for patients with other health conditions.
TCAR is a less invasive alternative with a smaller incision and a lower risk of nerve injury. Studies suggest TCAR has comparable success rates to CEA in preventing stroke while offering faster recovery.
How does TCAR compare to CAS?
Carotid artery stenting (CAS) is another minimally invasive option that involves threading a stent through the femoral artery in the groin and guiding it to the carotid artery. “While effective, CAS is associated with a slightly higher risk of stroke compared to TCAR,” said Dr. Cole. “Because TCAR uses a direct carotid approach with reversed blood flow, it helps reduce the chance of plaque traveling to the brain.”
What are the benefits of TCAR?
TCAR offers several advantages, including:
- A minimally invasive approach: Smaller incisions, less scarring and reduced recovery time
- Lower stroke risk: The reversal of blood flow helps prevent plaque from traveling to the brain
- Faster recovery: Many patients can go home the next day and return to normal activities sooner
- Reduced risk of nerve damage: Compared to CEA, TCAR has a lower chance of affecting nearby nerves
TCAR is a safer alternative for stroke prevention, especially for people considered high-risk for traditional surgery.
Are there risks associated with TCAR?
“As with any procedure, TCAR comes with some risks, including bleeding, infection and complications related to the stent placement,” said Dr. Cole. “But for many patients, the benefits outweigh the risks, especially for those who aren’t good candidates for open surgery.”
Who is a good candidate for TCAR?
TCAR may be recommended for patients who:
- Have carotid artery disease with a significant blockage
- Are at high risk for complications with traditional surgery
- Prefer a minimally invasive procedure with a faster recovery
Which treatment option is best for me?
The best treatment option depends on several factors, including your overall health, the severity of your carotid artery disease and your doctor’s recommendation. “If you’re at high risk for surgical complications, TCAR may be a safer choice,” said Dr. Cole. “But if you are otherwise healthy and eligible for CEA, traditional surgery may still be a viable option.”
Talk to a vascular specialist
If you or a loved one has been diagnosed with carotid artery disease, talking to a vascular specialist can help you understand your options. Both TCAR and traditional treatments have proven benefits, and the right choice depends on your individual health needs.
