Avera Medical Minute: TCAR surgery helps prevent stroke

SIOUX FALLS, S.D. - To prevent the possibility of a stroke, doctors at Avera are performing an innovative surgery called a TCAR. It stands for Transcarotid Artery Revascularization.

Henry Van Essen had a bypass surgery in 2005. He has made yearly visits to the doctor to get his heart and veins checked out. But, this year was different.

"It showed that it was worse than last year. So, then I went to my internist doctor and he suggested that we went this far," Van Essen said.

For Henry, his carotid artery was 80% blocked.

"It really was critically narrowed. We were concerned it would block off entirely and would lead to a stroke. So, this was really a stroke preventative strategy," Dr. Michael Bacharach said, who is a surgeon with Avera.

That preventative strategy was to perform a Transcarotid Artery Revascularization or TCAR for short.

"You make a small incision in the neck, just below the artery, and you have just a short distance to traverse to place the stent," Dr. Bacharach said.

After the incision, doctors then reverse the flow of blood using an innovative design by sending the blood through veins in the leg. Now that the blood is reversed, it then helps prevent any debris from moving up into the brain, causing a stroke before placing the stent.

"Everything seems to be working now," Van Essen said. "I am just glad that I am this far along. I think I'm through the worst."

Using this preventative surgery, it will help save lives and reduce the risk for strokes.

"The blockage in the neck blood vessels in the carotid arteries is one of the risk factors that leads to stroke, especially when the narrowing becomes severe. Now, if someone has a mini-type stroke or what we call a TIA or a stroke related to severe blockage, it absolutely needs to be fixed," Dr. Bacharach said.

After Henry's preventative surgery, he's ready to go and enjoy life.

"I think I can go another 20 years the way I feel now," Van Essen said.

The partnership between Avera and North Central Heart continues to allow innovation and new technologies, such as the TCAR, which provides safer ways to treat patients.