White River Health (WRH) is the first in North Central
Arkansas to treat carotid artery disease and prevent future strokes using an innovative procedure
called TransCarotid Artery Revascularization (TCAR). Mahesh Anantha, MD, FACC, FSCAI of
WRH is the first Interventional Cardiologist in Arkansas to perform this procedure in
collaboration with General Surgeons Jay R. Jeffrey, MD, FACS, and Luke Edgecombe, MD.
TCAR (tee-kahr) is a clinically proven and minimally invasive approach for patients who need
carotid artery treatment.
Every 40 seconds, someone in the United States has a stroke.1 Worldwide, nearly 5 million
people die from a stroke, and another 5 million are left permanently disabled every year.2 Carotid
artery disease is a form of atherosclerosis, or a buildup of plaque, in the two main arteries in the
neck that supply oxygen-rich blood to the brain. If left untreated, carotid artery disease can often
lead to stroke. With up to a third of strokes caused by carotid artery disease3, WRH offers
patients minimally invasive options such as TransCarotid Artery Revascularization (TCAR) to
prevent future strokes with a faster recovery time and an increased chance of being discharged to
TCAR is unique in that blood flow is temporarily reversed during the procedure so that any small
bits of plaque that may break off are diverted away from the brain, preventing a stroke from
happening. A stent is then placed inside the artery to stabilize the plaque, minimizing the risk of
a future stroke.
Prior to TCAR, the main treatment option for severe carotid artery disease was an open surgical
procedure called carotid endarterectomy (CEA). CEA removes plaque from inside the carotid
artery to restore normal blood flow to the brain, but the large incision leaves a visible scar the
length of the neck. CEA carries risks of surgical complications, including bleeding, infection,
heart attack, and cranial nerve injuries that can cause issues with swallowing, speaking, and
sensation in the face.
“This advancement represents a significant step forward in our efforts to combat cardiovascular
disease and improve the quality of life for those at risk,” said Dr. Anantha. “Transcarotid Artery
Revascularization, or TCAR is a groundbreaking technique that offers a minimally invasive
solution for patients at risk of stroke due to carotid artery disease. TCAR combines the benefits
of both traditional carotid endarterectomy (surgery) and stenting (carotid artery stenting via a
small incision in the groin without surgery), offering a safer and more effective method. By
utilizing a small incision at the base of the neck, we can directly access the carotid artery,
allowing for precise plaque removal and the insertion of a stent to restore blood flow. TCAR
reduces the risk of stroke during the procedure, and it promotes faster recovery times and better
long-term outcomes for our patients.

The TCAR® system was developed by Sunnyvale, California-based Silk Road Medical, Inc. and
includes the ENROUTE® Transcarotid Neuroprotection (NPS) and Stent System – the first
devices designed and FDA-approved specifically for TCAR. Over 70,000 TCAR procedures
have been performed worldwide through clinical trials and commercial use. TCAR has been
studied extensively, and the clinical data have been excellent. Additional information about
TCAR is available at http://silkroadmed.com/disease-and-treatment-options/.


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