TCAR Can Reduce Stroke Risk | News | Loyola Medicine

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Thursday, February 8, 2018

TCAR Helps Prevent Stroke During Carotid Artery Procedure

Illustration of carotid artery with blocked blood flow
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.
During the TCAR procedure, the brain continues to receive oxygenated blood from other arteries, including the carotid artery on the other side of the neck and vertebral arteries in the back of the neck.
"Throughout the procedure, we constantly monitor the patient's neurological status, and if necessary, we can stop the reversal of blood flow," said Loyola vascular surgeon Paul Crisostomo, MD.
Dr. Crisostomo said TCAR prevents strokes more effectively than any umbrella filters previously used.
Dr. Crisostomo and other surgeons in Loyola Medicine's division of vascular surgery and endovascular therapy use the latest open and less invasive endovascular procedures to treat a wide variety of arterial diseases. In addition to carotid stenting, procedures offered include carotid endarterectomy (open carotid surgery), angioplastyaortic aneurysm repair, atherectomy, bypass surgery, endovenous laser therapy and radiofrequency ablation. Vascular surgeons collaborate closely with other specialists, including neurologists, neurological surgeons, radiologists, cardiologists and cardiothoracic surgeons.

About Loyola University Health System

Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system that includes Loyola University Medical Center (LUMC), located on a 61-acre campus in Maywood, Gottlieb Memorial Hospital (GMH) on a 36-acre campus in Melrose Park, and convenient locations offering primary and specialty care services throughout Cook, Will and DuPage counties. At the heart of LUMC is a 547-licensed-bed hospital that houses the Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, a burn center, a certified comprehensive stroke center, a children's hospital, and Loyola Outpatient Center. The campus also is home to Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. The GMH campus includes a 247-licensed-bed community hospital, a Professional Office Building with 150 private practice clinics, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

About Trinity Health

Health is one of the largest multi-institutional Catholic health care delivery systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 93 hospitals, as well as 122 continuing care programs that include PACE, senior living facilities, and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $17.6 billion and assets of $23.4 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity Health employs about 131,000 colleagues, including 7,500 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity Health is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services — ranked by number of visits — in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs. For more information, visit You can also follow @TrinityHealthMI on Twitter.