Carotid artery stenting, also known as Transcarotid Artery Revascularization (TCAR), is a medical procedure used to treat carotid artery disease. The carotid arteries are major blood vessels located on each side of the neck, and they supply oxygen-rich blood to the brain. When these arteries become narrowed or blocked due to atherosclerosis (a buildup of plaque), it can lead to reduced blood flow to the brain, increasing the risk of stroke.
TCAR is a minimally invasive technique that combines elements of traditional carotid endarterectomy (CEA) and carotid artery stenting. It is performed to open up a blocked or narrowed carotid artery and restore proper blood flow to the brain, reducing the risk of stroke.
The TCAR procedure involves the following steps:
1. Access: The surgeon makes a small incision in the neck to access the carotid artery.
2. Blood flow reversal: A special device is used to temporarily reverse the blood flow in the carotid artery. This is important because it helps prevent any dislodged plaque or debris from flowing to the brain during the procedure.
3. Stent placement: A stent (a small, expandable mesh tube) is then inserted through the incision and positioned at the site of the blockage or narrowing. The stent is designed to widen the artery and improve blood flow.
4. Blood flow restoration: After the stent is in place, blood flow is returned to its normal direction.
5. Closure: The incision in the neck is closed, and the procedure is complete.
TCAR has been developed as an alternative to traditional carotid endarterectomy (CEA) and carotid artery stenting (CAS) to address some of their limitations. By temporarily reversing the blood flow, the risk of dislodging plaque and causing a stroke during the procedure is reduced. This technique is particularly useful for patients who are considered high-risk candidates for other forms of carotid revascularization.
It is important to note that TCAR is not suitable for all patients, and the decision on the most appropriate treatment method should be made after careful evaluation by a vascular surgeon or interventional specialist. As with any medical procedure, TCAR also carries some risks, and potential complications should be discussed thoroughly with the treating physician.