“One of the most common procedures that bring patients to our office are those who have developed severe blockages in the carotid arteries,” says Dr. Richard Sheppek, Vascular Surgeon at McLaren Northern Michigan in Petoskey. “When this plaque builds up and gets to be quite severe, the more severe it becomes, the higher the risk for stroke for a patient. And stroke is a leading cause of death in the United States—and not only death but significantly life-altering changes in your ability to care for yourself as time goes on.”
For decades, procedures have been in place to combat plaque build-up, but recently a new procedure has presented much safer outcomes. Instead of the traditional treatments, which include scraping off the plaque, or coming up from the groin to place a stent in the artery—both including risks of plaque breaking off and traveling to the brain, causing stroke—the TCAR Procedure is different. And for the first time, it’s being offered in Northern Michigan.
“TCAR stands for TransCartoid Artery Revascularization,” explains Dr. Sheppek. “You set up a system where you actually reverse the blood flow of the carotid artery. So if by chance in your attempt to get your stent in, or get a wire across the blockage (where you might knock something off)—rather than that piece traveling up to the brain, it instead gets washed out into the external flow circuit that has a filter in it, and after the blood is filtered, it gets returned to a vein down in the groin.”
Dr. Richard Sheppek // Photo courtesy of McLaren Northern Michigan
“Doing it in this fashion with what’s called flow reversal, the risk of stroke in trying to reverse the blockage has been dropped to the lowest that’s ever reported in any of these procedures and that’s around 1.4 percent,” Dr. Sheppek shares. “And that’s significant improvement; I don’t think you can get it any better than that. Having done all three procedures, I completely understand why this procedure is as safe as it is.”
Currently, the procedure is limited to high-risk patients who qualify. However, Dr. Sheppek feels that as soon as 2020 they “might be able to open it up to standard-risk patients because it really has proven that each step of the way it’s a very safe and reproducible advance.”
“I believe TCAR is the future of carotid repair,” Dr. Sheppek says.
What are the Carotid Arteries?
The major blood vessels in our neck that supply blood to the brain, face and neck are called carotid arteries. Untreated buildup of plaque in these arteries, or carotid artery disease, leads to stroke. In fact, it’s estimated that up to one-third of strokes are caused by a blockage in carotid arteries, with 400,000 new diagnoses of the disease made every year in the U.S. alone.