HCA Virginia
August 06, 2019

Richmond, Virginia — HCA Virginia's Henrico Doctors' Hospital is offering a new procedure to treat carotid artery disease and prevent future strokes through Trans Carotid Artery Revascularization (TCAR) — a clinically proven, minimally invasive, and safe approach for high surgical risk patients who need carotid artery treatment.

Henrico Doctors' was the first in the Greater Richmond area to perform the TCAR, which involves accessing the carotid artery through a small incision above the collarbone. A vascular surgeon then delivers a stent directly into the artery, which reduces the risk of stroke and other complications associated with traditional stenting or surgical methods.

"Minimally invasive technologies have not been able widely adopted in the field of carotid surgery because standard carotid stenting from the groin has a two-time higher risk of stroke than more conventional approaches," said Andrew Leake, M.D., vascular surgeon at Henrico Doctors' Hospital. "We haven't had many options for carotid disease until now."

Carotid artery disease (CAD) 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, CAD can often lead to stroke; it is estimated to be the source of stroke in up to a third of cases, with 400,000 new diagnoses of the disease made every year in the U.S. alone.

Prior to this intervention, the main treatment option for severe CAD 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 risks of surgical complications, including bleeding, infection, heart attack, and cranial nerve injuries.

"We're really adopting it and seeing great results from the TCAR procedure," said Leake. "Patients are going home earlier with significantly less pain, smaller incisions and are able to get back into their routines relatively quickly."