PVA One of the First to Offer Innovative TCAR Procedure - Peripheral Vascular Associates
PVA One of the First to Offer Innovative TCAR Procedure - Peripheral Vascular Associates

PVA One of the First to Offer Innovative TCAR Procedure


Vascular Physicians at PVA Take Leap Forward with Minimally Invasive Technology Temporarily Reversing Blood Flow in the Brain to Prevent Devastating Strokes

Peripheral Vascular Associates (PVA) is one of the first physician groups in the state to perform an innovative treatment for patients at risk for stroke due to blockages in the neck arteries known as carotid artery disease. The minimally invasive procedure, called TransCarotid Artery Revascularization, or TCAR, utilizes a new FDA-approved neuroprotection system that temporarily reverses blood flow in the artery during the procedure.  Dangerous bits of plaque and blood clots that could dislodge and otherwise travel to the brain and cause a stroke are safely diverted away while a dedicated transcarotid stent is inserted to open and stabilize the blockage.

Prior to TCAR, the main treatment options for severe carotid artery disease were an open surgical procedure called carotid endarterectomy and a carotid stent. The surgical technique allows for protection of the brain during the procedure but carries risks of complications including bleeding, infection, heart attack, and cranial nerve injuries that can cause issues with swallowing, speaking, and sensation in the face.

Carotid stenting is less invasive but still carries about the same stroke risk. In some instances, the stroke rate may be higher.

The vascular surgeons at PVA are among the first to gain expertise with the TCAR procedure.  “TCAR is a hybrid procedure that combines the best of open surgery and stenting. It gives us the excellent neuroprotection we expect from carotid endarterectomy, but the procedure is less invasive which has a real benefit to the patient. They recover quickly with less pain, and the risks of both minor and major complications are significantly decreased,” explained Dr. Jeffrey Martinez, PVA President. “It represents the modernization of carotid repair in appropriate patients.”

Results from clinical trials of TCAR were so compelling that the Society for Vascular Surgery (SVS), in collaboration with the Food and Drug Administration (FDA) and the Centers for Medicare and Medicaid Services (CMS), recently launched a novel program called the TCAR Surveillance Project.  This program provides expanded insurance coverage of TCAR procedures for Medicare beneficiaries while allowing individual hospitals and the society to track quality benchmarks.

Every year, 15 million people worldwide suffer a stroke, also known as a “brain attack.” Nearly six million dies and another five million are left permanently disabled. Stroke is the second leading cause of disability globally. Carotid artery disease is estimated to be the source of stroke in up to a third of cases and there are 400,000 new diagnoses of carotid artery disease made every year in the United States alone.[1],[2]

“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 endarterectomy due to age, other medical conditions, or anatomic issues.  Because of its low stroke risk, we think TCAR has the potential to become the standard of care for all patients,” said Dr. Boulos Toursarkissan, a vascular surgeon at PVA.

About PVA

Founded in 1975, Peripheral Vascular Associates (PVA) has become one of the largest single specialty vascular groups in the nation. We are committed to providing complete and comprehensive state-of-the-art care to the residents of San Antonio and South Texas. Our mission is to continually work with our physician colleagues in the management of any vascular problem, to provide education to the community about the risk factors associated with peripheral arterial disease (PAD), and to maintain our position as the leader in vascular care. With 23 vascular surgeons and 20 convenient clinic locations located throughout South Texas, PVA is committed to offering the best vascular care for every patient, every day.

 About TCAR with the ENROUTE Transcarotid Neuroprotection and Stent System

The ENROUTE® Transcarotid Neuroprotection (NPS) and Stent System from Silk Road Medical, Inc. are the first devices designed and FDA-approved specifically for TCAR.  The ENROUTE Transcarotid Stent is indicated for use in High Surgical Risk patients and is intended to be used in conjunction with the ENROUTE Transcarotid Neuroprotection System (NPS). The ENROUTE Transcarotid NPS is used to directly access the common carotid artery and initiate high rate temporary blood flow reversal to protect the brain from stroke while delivering and implanting the ENROUTE Transcarotid Stent.

[1] http://www.world-heart-federation.org/cardiovascular-health/stroke/

[2] https://vascular.org/patient-resources/vascular-conditions/carotid-artery-disease

Source: Peripheral Vascular Associates (PVA)
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