Thanks to her TCAR procedure with Adam B. Levitt, M.D., R.V.T., F.A.C.S., a board-certified vascular surgeon at Vascular Specialists of Central Florida, Mable is now free from carotid artery disease. She can now rest easy knowing her risk of having a stroke has been significantly reduced.
TCAR, which stands for transcarotid artery revascularization, is a new minimally-invasive procedure that employs a special device to briefly reverse the direction of blood flow. With blood (and any clots) flowing away from the brain while the physician operates, the patient’s risk of stroke during the procedure is lower.
“I had a transcarotid artery revascularization (TCAR) procedure done by Dr. Levitt,” says Mable. “Afterward, I had no problems, no pain, and I certainly didn’t end up with a scar (down my neck) like everybody else. Mine is tiny. I was very pleased with Dr. Levitt. He’s a fantastic doctor.”
What Is Carotid Artery Disease?
The carotid arteries of the neck are the major pathways that provide oxygen-rich blood to the brain. When gummy plaque builds up in the carotid arteries (a process known as atherosclerosis), blood flow to the brain is impeded. As a result, the plaque can break off and get lodged in the brain, and a stroke can occur.
Smoking, obesity, high levels of cholesterol, high blood pressure, elevated blood sugar from diabetes, and physical inactivity can damage the inner lining of the carotid arteries. To help repair the arteries, the body will manufacture a sticky substance called plaque. If the plaque fractures or bursts, blood platelets can bind to the injured area and may cluster together to form blood clots. The formation of blood clots can severely impede the flow of blood to the brain.
“During a visit with my primary (physician), I was told that I had a blockage on the right side,” says Mable. “My primary doctor wanted Dr. Levitt to examine me because he heard something in my neck he didn’t like.”
During her appointment, Dr. Levitt conducted tests which revealed a severe blockage in Mable’s carotid artery. “I came in to see Dr. Levitt, and he determined that it was close to 90% blocked. Dr. Levitt said that I needed to get the TCAR procedure done. He explained the surgery, told me exactly what was going to happen, and made me feel very comfortable about it.”
What Is the TCAR Procedure?
A potential complication of both surgery (carotid endarterectomy, or CEA) and stenting for stroke prevention in patients with carotid artery disease is a stroke occurring during the procedure itself.
TCAR is unique because blood flow is temporarily reversed during the procedure so that any tiny bits 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.
“Mable had carotid artery disease,” says Dr. Levitt. “And we offered transcarotid artery revascularization as a new form of treatment for her condition. The standard therapy is a carotid endarterectomy or transfemoral stenting. However, the TCAR procedure is a hybrid procedure between the two that has been shown to have the lowest stroke rate of all procedures available for carotid artery disease.”
The TCAR procedure is performed through a small incision at the neckline just above the clavicle. This incision is much smaller than a typical CEA incision. The surgeon places a tube directly into the carotid artery and connects it to the device that directs blood flow away from the brain.
“We scheduled surgery, and I went in one day and came out the next,” says Mable. “And after the surgery, the doctor that assisted Dr. Levitt, who had done the TCAR procedure many times, came in and told me what a success it was.”
Recovering After TCAR
Patients who undergo the TCAR procedure recover quickly, typically spending just one night in the hospital. Moreover, most patients can return home the next day to resume full and productive lives with less pain, smaller scars, and a reduced risk of future strokes.
“We performed this procedure on Mable, and she did great,” says Dr. Levitt. “She was discharged on day one and had minimal symptoms of discomfort. She’s very happy with her results, and so are we.”
Grateful for having her carotid artery flowing freely again, Mable wouldn’t hesitate to recommend Dr. Levitt to others experiencing the same blockage and risks as she did.
“I would definitely recommend Dr. Levitt,” she says. “He’s a competent and very comfortable physician. He doesn’t make you feel bad or anything. I felt very, very relaxed, and very sure about the outcome of it. I wasn’t nervous or anything at all when we went into surgery.”
Are You a Candidate for TCAR?
Your physician may recommend the TCAR procedure if you’ve been diagnosed with carotid artery disease and are not a suitable candidate for CEA. This may depend on your age or other existing medical conditions.
For more information about carotid artery disease or TCAR, please feel free to contact us.