A less invasive procedure now available in vermont for veterans susceptible to stroke | va white river junction health care | veterans affairs

Kara Latchaw, Radiology Technologist; Alexis Cascadden, Physician Assistant, Vascular Surgery; David Stone, Section Chief, Vascular Surgery; & Jesse Columbo, Vascular Surgery stand in

the Vascular Surgery Suite at White River Junction VA Healthcare System (WRJ VA). This team helped bring the TCAR procedure to the WRJ VA. By Katherine Tang, Public Affairs Officer April 25,

2022 In the world of healthcare, everything is evolving and advancing. The more that is accomplished, the more we learn and adjust which is how life expectancy has shifted over the

generations. At the White River Junction VA Healthcare System the vascular surgeons successfully performed a newer procedure called Transcarotid Artery Revascularization or TCAR. The carotid

arteries are the major blood vessels that deliver oxygenated blood to the brain and where many people check for a heartbeat as it is easily felt just under the jaw on either side of the

neck. Those seeking a procedure like the TCAR typically have carotid artery disease which is a diagnosis given when fatty deposits or plaques create a narrowing of those major blood vessels.

Historically the procedure given to treat carotid artery disease is the Carotid Endarterectomy which is when a surgeon makes an incision in the anterior (front) region of the neck to expose

the affected carotid artery. The surgeon will then open the artery enough to remove the plaque build up allowing unrestricted blood flow to the brain. This will in turn reduce the chances

of a stroke. With the TCAR technique patients with blockage in their carotid arteries will have the surgeon make a small incision at the base of the neck near the clavicle (collar bone) and

place a tube directly into the carotid artery to transiently reverse the flow of blood from the affected blood vessels which provides cerebral protection or more simply prevents a piece of

plaque from embolizing (clotting) to the brain. This procedure effectively has blood flow through the tubing system where any material that may be displaced will be filtered outside the

body. Once flow is reversed via the tubing system, the surgeon can safely place a stent across the carotid artery blockage which opens the vessel while also stabilizing the plaque. After the

stent is secured in place, blood flow is restored to normal antegrade circulation. This technique allows clinicians to treat patients at risk for a stroke with carotid artery disease who

may be at high risk for the more conventional carotid artery surgery, Carotid Endarterectomy. Recovery is relatively quick, patients can expect only 1-2 nights in the hospital. Dr. Phil

Goodney and Dr. David Stone of the White River Junction VA Healthcare System performed the first TCAR at the VA Medical Center in Vermont on Tuesday March 8th, 2022. The procedure was

successful and the team continues to review patient cases for appropriateness. Revolutionary advancements would not exist in healthcare without research, flexibility and the drive to

continue to be the best for those we treat. Science is ever evolving and at the White River Junction VA Healthcare System we strive to provide the best care possible to our Veterans. Thank

you to the team of vascular surgeons who continue to advance their practice for the benefit of not only the Veterans they treat but the advancement of healthcare worldwide.