Carotid endarterectomy

When peripheral artery disease (or PAD) is caused by a blood vessel blockage in the carotid artery in the neck, it may narrow blood flow to the arms or legs, increasing chances for stroke. One peripheral artery disease treatment option is a surgical procedure called carotid endarterectomy.

In this procedure, the vascular surgeon at our Dallas heart hospital makes an incision on the front of the patient’s neck, opens the carotid artery, removes any blockages and then stitches the artery closed.

Carotid endarterectomy surgery may be performed following a stroke and can also help prevent strokes.

Carotid stenting

Another surgical procedure to treat peripheral artery disease is the placement of a carotid artery stent—a very small wire mesh coil—to keep coronary arteries open.

As part of a minimally invasive procedure at our heart hospital in Dallas, known as coronary angioplasty, the vascular surgeon makes a small incision in the patient’s groin, arm or neck and then inserts a catheter with the stent containing a balloon on the tip into a blocked section of the coronary artery. Using special dyes and monitors to guide the catheter through the blood vessels to a narrowed artery, the balloon is inflated at the site of the blockage, expanding the stent to permit increased blood flow. After the artery is stretched and opened, the physician deflates the balloon and removes the catheter, leaving the stent behind.

At Baylor Scott & White Heart and Vascular Hospital – Dallas, vascular surgeons on the medical staff regularly perform carotid stenting procedures.

Transcarotid artery revascularization (TCAR)

Thanks to specialty training by vascular surgeons on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas, a relatively new procedure is now available to patients to help resolve blockages in the carotid artery that could lead to stroke. Transcarotid artery revascularization (TCAR) combines the safety and reliability of open carotid endarterectomy with the minimally invasive features of carotid stenting.

During TCAR, a vascular surgeon at our Dallas heart hospital makes a small incision just above a patient’s collar bone to expose the common carotid artery. A soft, flexible sheath is placed directly into the carotid artery, connected to a specialized system to reverse the blood flow away from the brain to protect against fragments of plaque that may come loose during the procedure. The blood filters and returns through a second sheath placed in the femoral vein in the patient’s thigh, and then the stent is inserted to open the artery.

Vascular surgeons on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas continue a long history and tradition of innovation with the TCAR procedure, often an alternative to carotid endarterectomy.