Transcarotid Artery Revascularization (TCAR) is a clinically proven, minimally invasive procedure to treat carotid artery disease and help prevent future strokes. TCAR is unique in that blood flow is temporarily reversed during the procedure so that any bits of plaque that may break off are diverted away from the brain.

Stroke prevention is paramount, and at St. Clair Health, a team of vascular surgeons is working to further reduce stroke risk in persons with carotid artery disease (CAD), a leading cause of stroke, with an innovative procedure known as transcarotid arterial revascularization, or TCAR (pronounced tee car). For Tom Simone, M.D., and his partner Samuel T. Simone, Jr., M.D. (Tom’s father), TCAR is proving to be a patient-friendly and highly effective alternative to traditional CAD treatment, for selected patients.

TCAR is the latest technology and a powerful adjunct to the conventional approaches to CAD. The carotid arteries are like two parallel superhighways on each side of the neck, transporting fresh, oxygen-rich blood straight from the heart to the brain, the body’s command center. Their patency, or openness, is vitally important, but as we age, they may become narrow as a substance known as plaque accumulates along the vessel walls. Gradually, the space narrows (stenosis) and the artery becomes stiff; eventually the stenosis may lead to complete occlusion or closing. The plaque that lines the carotid arteries is composed of mostly fat and cholesterol, and is exactly the same as the plaque that coats the walls of the coronary arteries. This process, atherosclerosis, is actually a systemic condition, and when left untreated, can be equally lethal in the brain or the heart, producing stroke or heart attack.

The goal of treatment in carotid artery disease is to reduce the risk of stroke. Often, carotid artery disease can be medically managed to slow its progression. Medical treatment is the first line of defense in treating carotid artery disease. Low dose aspirin, medications to lower cholesterol (statins) and blood pressure, and smoking cessation are part of treatment. 

TCAR is not indicated for every patient who needs CAD surgery, but is for those with an increased risk of stroke or other complications. The procedure makes it possible for individuals previously considered too high risk for carotid artery surgery to undergo this brain preserving treatment.