Three Norton Healthcare hospitals have been recognized as centers of excellence for transcarotid artery revascularization (TCAR) treatment for carotid artery blockages.

Published: March 15, 2021 | Updated: June 21, 2023

Carotid artery blockage treatment, typically medication at first and eventually surgery in more severe cases, can reduce the risk of stroke or worse. Plaque buildup in arteries that supply blood to the brain could cause serious damage if pieces break off and reach the brain.

Carotid artery blockages cause up to a third of strokes, according to Stephen B. Self, M.D., vascular surgeon with Norton Heart & Vascular Institute.

“Not all patients need surgery right away to treat carotid disease,” Dr. Self said. “Drug therapies are often the first line of defense.”

Addressing blockages in more severe cases may require surgery. Traditionally, surgeons have treated the blockage by opening the artery through an incision along the entire neck, then removing the plaque manually — a carotid endarterectomy. A conventional stent also can be used to treat the blockage.

“However, both options have limitations and actually carry a risk of stroke during the procedures themselves,” Dr. Self said.

Reversing blood flow to reduce risk of stroke during the procedure

A minimally invasive procedure — transcarotid artery revascularization (TCAR) — has been developed in recent years for patients who face high risk of complications from traditional surgery.

Using the TCAR (pronounced TEE-kahr) procedure, physicians access the blockage through a small incision in the chest just above the clavicle bone. Blood flow temporarily is reversed so any clots are flowing away from the brain while a stent is placed in the carotid artery to stabilize the blockage.

During the blood flow reversal, oxygen-rich blood is filtered outside the body and returned to the brain through other arteries.

Silk Road Medical, maker of the TCAR device, has recognized Norton Audubon Hospital, Norton Brownsboro Hospital and Norton Hospital as TCAR Centers of Excellence. The designation is a result of excellent patient outcomes through appropriate patient selection and the well-trained and credentialed vascular specialist teams.

“TCAR is an important new option in the fight against stroke and is particularly suited for the large portion of patients we see who are at higher risk of complications from carotid surgery