PHOENIX — A procedure being used in some Arizona hospitals can lower the risk of stroke or heart attack for patients with carotid artery disease.

Transcarotid Artery Revascularization, or TCAR, uses a small incision in the neck and a thin wire to treat blockages and get patients on the road to recovery quickly.

“(TCAR) avoids the arch of the aorta, which can be very tortuous,” Dr. Venkatesh Ramaiah, a vascular surgeon at Abrazo Arizona Heart Hospital, said.

The old way of treating blockages in patients — going through the groin and crossing an artery with a wire — was dangerous in the best of circumstances.

Read More: http://ktar.com/story/1933576/procedure-lowers-stroke-heart-attack-risk-for-some-at-arizona-hospitals/

HOLLYWOOD, Fla. — Several new technologies are available or on the horizon to improve the outcomes of carotid artery stenting, according to a speaker at the International Symposium on Endovascular Therapy (ISET).

“There has been some suppression of carotid activity in the [United States] largely based on reimbursement limitations. This has been challenging but, despite that, there has been a plethora of new technologies for carotid stenting which are meant to address some pivotal opportunities,” William A. Gray, MD, system chief of the division of cardiovascular disease at Main Line Health and president of the Lankenau Heart Institute in Wynnewood, Pennsylvania, said during a presentation.

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Next, there is direct carotid access with high flow reversal with transcarotid artery revascularization (TCAR) using the Enroute device (Silk Road Medical). This technology allows for a small surgical incision above the clavicle for direct carotid access and initiation of high flow reversal into a venous circuit with a filter to protect the brain from stroke while delivering and implanting the Enroute Transcarotid Stent. Data from the ROADSTER trial showed a very low rate of stroke, including in high-risk subgroups who are symptomatic and aged older than 75 years. Additionally, TCAR showed fewer diffusion-weighted imaging abnormalities after the procedure and comparable to CEA, which Gray said demonstrates mechanistic proof of improved embolic protection.

Read More: https://www.healio.com/cardiac-vascular-intervention/cerebrovascular/news/online/%7Bda09ac85-dbfd-48e6-af7a-d634d4c7bae6%7D/new-technologies-for-carotid-stenting-show-promise?page=2

The ‘thrombectomy’ is transforming stroke care, pre-empting brain damage in many patients, but the medical establishment is far from making it standard practice

Minutes mattered to two Atlanta-area residents who showed severe-stroke symptoms last autumn. The right treatment done quickly can help prevent brain damage.

An ambulance raced a 74-year-old man to a hospital nearby that wasn’t an institution capable of offering the most-advanced procedure. He arrived Oct. 30 at 9:30 a.m. with right-side weakness, unable to speak.

Those symptoms should have been enough for personnel to immediately transfer him to Grady Memorial Hospital, says Raul G. Nogueira, Grady’s chief of stroke endovascular therapy, who treated him and recounted the case. Grady can perform a procedure called “thrombectomy” that is gaining favor for its ability to pre-empt brain damage in many patients.

Read More: https://www.wsj.com/articles/a-treatment-is-revolutionizing-stroke-carebut-not-everyone-receives-it-1517933226?mg=prod/accounts-wsj

Loyola First Academic Medical Center in Illinois to Offer TCAR Procedure

Newswise — MAYWOOD, IL – Loyola Medicine is the first academic medical center in Illinois to use the TCAR system, which reduces stroke risk during carotid artery procedures by temporarily reversing blood flow.

Carotid arteries on each side of the neck supply blood to the brain. In patients with carotid artery disease, a build-up of plaque can cause blockages. A common method to open the artery involves a balloon angioplasty and stent placement. The physician inserts a balloon catheter in the groin and guides it through various blood vessels up to the carotid artery. At the site of the blockage, the tiny balloon is inflated to open the artery. A stent then is placed to ensure the artery remains open.

The procedure can knock loose pieces of plaque, and the debris can travel to the brain and cause a stroke. The traditional way to prevent this is to place an umbrella-shaped filter in the carotid artery. However, small pieces of plaque can still make it through the filter and cause small strokes. Also, placing the filter itself can knock loose plaque debris.

TCAR (Transcarotid artery revascularization) prevents debris from flowing up to the brain during the procedure. The carotid artery is connected to a system that reverses the flow of blood away from the brain. The blood is filtered and returned to the femoral vein in the patient's thigh. After the stent procedure is completed, the TCAR system is removed and blood flow returns to normal.

Read More: https://www.newswise.com/articles/reversing-blood-flow-reduces-stroke-risk-during-carotid-artery-procedure