Bayhealth Performs First TCAR Procedure

Bayhealth Performs its First TCAR Procedure to Treat Carotid Artery Disease

Thursday, October 29, 2020 | Heart and Vascular, Neurosciences, Stroke Care

Bayhealth now offers a new procedure called TCAR (Transcarotid Artery Revascularization) to treat high surgical risk patients with carotid artery disease and prevent future strokes. TCAR is a minimally invasive and safe approach that is clinically proven to reduce the risk of stroke for patients needing stenting for clogged carotid arteries in order to improve blood flow to the brain. Vascular and Thoracic Surgeon Paul Fedalen, MD, was the lead surgeon for the first TCAR performed at Bayhealth Hospital, Kent Campus. He was joined by Interventional Cardiologist Khaled Eljazzar, MD, and Interventional Neurologist Sumeet Multani, MD, in launching Bayhealth’s TCAR program and successfully completing the first case.

Carotid artery disease is a form of atherosclerosis, or a buildup of plaque, in the two main arteries in the neck that supply oxygen-rich blood to the brain. If left untreated, carotid artery disease can often lead to stroke; it is estimated to be the source of stroke in up to a third of cases, with 427,000 new diagnoses of the disease made every year in the U.S. alone.

“It is exciting to be involved in this new technique to revascularize the carotid artery,” said Dr. Fedalen. “At Bayhealth the TCAR program is a collaborative effort between vascular surgery, interventional cardiology and interventional neurology. Dr. Eljazzar, Dr. Multani and I have taken a multidisciplinary approach to evaluate and treat this common problem in our community. Our first case was a success and very encouraging to the growth of our program.”

Produced by Silk Road Medical Inc., the ENROUTE® Transcarotid Neuroprotection and Stent System are the first devices designed and FDA-approved specifically for TCAR.

TCAR is unique in that blood flow is temporarily reversed during the procedure so that any fragments of plaque that may break off are diverted away from the brain, preventing a stroke from happening. A stent is then placed inside the artery to stabilize the plaque, minimizing the risk of a future stroke.

Prior to TCAR, the main treatment option for severe carotid artery disease was an open surgical procedure called carotid endarterectomy (CEA). CEA removes plaque from inside the carotid artery to restore normal blood flow to the brain, but the large incision leaves a visible scar the length of the neck and carries some 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. A less invasive procedure, TCAR involves a small incision made just above the collar bone. Typical patient benefits include a shorter and safer procedure and faster recovery.

“TCAR is an important advancement in treating carotid artery disease and a new option in the fight against stroke that will greatly benefit our community,” said Vice President of Ancillary and Clinical Services Brad D. Kirkes, MBA, MHA, OTR/L, CHT, FACHE. “Some individuals may be at a higher risk of complications with the alternative surgical approach, based on age or medical history, so we are very proud to offer this groundbreaking procedure that represents the future of carotid repair, offering less risk and quicker recovery time for our patients.”

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