Mercy Health physician and endovascular surgeon Sean Malarkey, DO, offers a procedure called transcarotid artery revascularization (TCAR) that can help patients reduce their risk of stroke from carotid disease – and from the treatment options for carotid disease.

“Patients with narrowing of the carotid arteries in the neck due to a build-up of plaque, a condition known as carotid stenosis, are candidates for TCAR. The condition is associated with transient ischemic attack (TIA). The plaque in their arteries can break off and move to the brain, leading to TIA. TIA causes symptoms similar to a stroke and is sometimes called a ministroke. About one-third of patients who experience TIA will one day go on to have a stroke,” Dr. Malarkey says.

Symptoms of TIA include blindness, tingling, numbing and facial droop, but many people have no sign that their carotid arteries have narrowed.

“Many patients will learn that they have carotid stenosis by accident following a screening ultrasound,” Dr. Malarkey says. “If you are over 60 and have a history of blockages elsewhere in your body, talk with your doctor about having a screening ultrasound.”

Dr. Malarkey, who practices from Mercy Health – West Hospital, notes that TCAR is a hybrid procedure, combining minimally invasive endovascular techniques with a limited amount of surgery. TCAR is a revascularization procedure that treats the stenosis and improves blood flow to the brain to reduce a patient’s future risk of suffering a stroke.

“To perform TCAR, I make a small incision just above the patient’s collarbone to access the carotid artery at the base. I place a sheath in the artery and hook the patient up to a device that filters the blood through a sieve before it reenters the patient. The filter ensures that no part of the potentially stroke-causing blockage breaks off into the patient’s bloodstream,” Dr. Malarkey says. 

Once the blood filtering device is in place, Dr. Malarkey removes the blockage and places a stent to open the artery. 

“The advantage of TCAR versus surgical procedures that introduce a stent through the groin artery is that with TCAR, I never cross the blockage before treating it. That lessens the risk of the patient having a stroke due to the procedure to treat their stenosis,” Dr. Malarkey says.

The procedure takes about 45 to 60 minutes and patients don’t have to go under general anesthesia if they don’t want to. Recovery is immediate and patients can sit upright and eat following the procedure. Most patients will spend one night in the hospital for the care team to monitor their blood pressure.

Dr. Malarkey practices from Mercy Health — General, Laparoscopic and Vascular Surgery, West, 3300 Mercy Health Blvd., Suite 2010, Cincinnati, Ohio 45211. For more information or to make an appointment, please call 513-686-5392.