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Vascular surgeons at Lehigh Valley Health Network (LVHN) are performing a new, minimally invasive procedure for patients like Alan Pollock, whose carotid artery disease put him at risk for stroke. The 77-year-old from Plains, Pa., underwent transcarotid artery revascularization, or TCAR, and was working at his machine shop within three days. “Things were very serious with my condition. But thanks to Lehigh Valley Hospital, I’m healthy and feeling great,” Pollock says.
Carotid stenosis concern
Pollock suffered from carotid stenosis, or narrowing of the arteries in the neck. It occurs when plaque builds up in the carotid arteries. Pollock’s mother had carotid artery disease and experienced a stroke during traditional surgery to clear the stenosis. “That really stuck in mind, so my wife, Dorothy, started researching other options,” Pollock says. When the Pollocks discovered that LVHN vascular surgeon James Guzzo, MD, performs TCAR, they recalled that he had successfully operated on their son’s leg and made an appointment.
New stenting approach
Guzzo and vascular surgeon Mila Ju, MD, have performed more than two dozen TCAR procedures. A 1-2- centimeter incision is made above the collarbone to place a shunt into the carotid artery, which temporarily reverses the flow of blood away from the brain. Then a stent is placed to reopen the artery. Any bits of plaque dislodged during the procedure are safely sent into an external filter. This significantly reduces the risk that plaque will travel to the brain and cause a stroke during surgery. The entire procedure usually takes about an hour, can be done awake or with general anesthesia, and patients can go home the next day.
Safety breakthrough
“TCAR is a breakthrough that gives surgeons an additional tool that allows them to safely treat complex, high-risk surgical patients who would not be offered traditional carotid repair,” says Guzzo, Chief of the Division of Vascular and Endovascular Surgery, with LVPG Vascular Surgery. His colleague, Ju, says TCAR reduces stroke risk. “TCAR has demonstrated the lowest stroke rate in clinical studies to date, including surgical endarterectomy or transfemoral stenting, and is a good choice for patients who are considered high risk for traditional surgery due to age, anatomic issues and other medical conditions.” Pollock says the TCAR procedure has restored his energy and enthusiasm. “There’s still a lot of fun to be had,” he says. “My wife and I want to take a cruise, and I’m going to get a golf club back in my hand. I’m so grateful to the doctors and nurses at Lehigh Valley Hospital that I have a normal life.”
– Janet McIntyre