Houston Methodist Sugar Land Hospital is treating  carotid artery disease and preventing future strokes using a new procedure called TransCarotid Artery Revascularization (TCAR), a clinically proven, minimally invasive and safe approach for patients who need carotid artery treatment.


Carotid artery disease 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, carotid artery disease 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. Stroke is the fifth leading cause of death in the U.S and the leading cause of disability.


“TCAR is an important new option in the fight against stroke, and it is particularly suited for the large portion of patients we see who are at higher risk of complications from carotid surgery due to age, anatomy, or other medical conditions,” said Charlie Cheng, M.D., board-certified vascular surgeon with Houston Methodist Cardiovascular Surgery Associates at Sugar Land. “Because of its low stroke risk and faster patient recovery, I believe TCAR represents the future of carotid treatment.”


TCAR is unique because blood flow is temporarily reversed during the procedure so that any small 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.


Prior to TCAR, the main treatment option for severe carotid artery disease was a surgical procedure called carotid endarterectomy (CEA). CEA removes plaque from inside the carotid artery to restore normal blood flow to the brain, but the 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 that can cause issues with swallowing, speaking and sensation in the face. The other option is to place a stent from arterial access in the groin. Risk of stroke is minimized through the use of a filter basket to trap any potential plaque from going to the brain. However, because the flow is not reversed, the risk of stroke is still there.


Over 13,000 TCAR procedures have been performed worldwide through clinical trial and commercial use. TCAR has been studied extensively, and the clinical data have been excellent.