Sharp Grossmont First in San Diego to Offer Innovative Surgery to Treat Carotid Artery Disease
Minimally invasive technology temporarily reverses blood flow in the brain to prevent serious strokes.
Sharp Grossmont Hospital is the first in San Diego County to offer an innovative treatment for patients at risk for stroke due to carotid artery disease, which is caused by plaque buildup in the neck arteries.
The minimally invasive procedure, called transcarotid artery revascularization (TCAR), is performed by Dr. Scott Musicant, a vascular surgeon affiliated with Sharp Grossmont Hospital. The TCAR procedure is used to stabilize plaque in the carotid arteries and decrease future potential for that plaque to fragment, break free, travel to the brain and cause a stroke.
TCAR also helps avoid stroke during the procedure itself by using a novel, FDA-approved system that temporarily reverses blood flow in the arteries that deliver blood to the brain. During the TCAR procedure, bits of plaque and blood clots in the artery may break free, but TCAR flow reversal safely diverts these dangerous materials away from the brain throughout the procedure.
With TCAR, the surgeon makes a small incision just above the collarbone and places a tube directly into the carotid artery. The tube is connected to a circuit outside the body that temporarily directs blood flow away from the brain. Throughout the procedure, any debris that may break loose is captured in a filter built into the circuit. The filtered blood is then returned to the body through another tube in the upper thigh. As the blood is being redirected and filtered, the surgeon inserts a stent in the carotid artery to stabilize plaque, decreasing the potential for future stroke. After the stent is placed, flow reversal is turned off and blood flow resumes in its normal direction.
Prior to TCAR, the traditional treatment option for severe carotid artery disease was open surgery (carotid endarterectomy). However, unlike open surgery, TCAR has shown to have fewer surgical complications such as bleeding, infection, heart attack and cranial nerve injuries that can cause issues with swallowing, speaking and sensation in the face.
"With TCAR, surgeons now have a less invasive option for patients at risk for traditional surgery. The potential for procedural or long-term stroke is very low and we can avoid some of the complications of open surgery, such as nerve damage, infection and procedural heart attack," says Dr. Musicant. "And unlike open surgery, there is less of a scar left behind, since the incision made is smaller."
According to the World Heart Federation, 15 million people worldwide suffer a stroke yearly, with nearly 6 million deaths and 5 million people permanently disabled due to stroke. Stroke is the second leading cause of disability globally. In the United States, the Society for Vascular Surgery reports that carotid artery disease is responsible for up to one-third of all strokes, and there are 400,000 new diagnoses of carotid artery disease made every year.
About Sharp Grossmont Hospital
Sharp Grossmont Hospital has been serving the East County community for 60 years. It is the largest not-for-profit, full-service, acute-care hospital in San Diego's East County and is part of Sharp HealthCare. The hospital is known for its clinical excellence in emergency and critical care, cardiac and cancer care, surgery, stroke care, orthopedics, rehabilitation, behavioral health, women's and children's health and hospice care. The hospital offers extensive outpatient services and prevention programs such as home infusion, sleep disorder care, wound care and hyperbaric medicine to support Sharp HealthCare's emphasis on community health and wellness. Sharp Grossmont is a Magnet-designated hospital and committed to providing the highest quality care.