VASCULAR SURGERY
Carotid Endarterectomy ( CEA )
At Baylor Scott & White Heart and Vascular Hospital - Dallas , vascular surgeons possess extensive experience to diagnose and treat patients who may need surgical intervention for atherosclerotic plaque buildup in the carotid arteries , a potentially dangerous health condition . Plaque accumulation can block blood flow to the brain or break into small particles leading to a transient ischemic attack , mini-stroke , or permanent , disabling stroke . The main treatment for atherosclerotic plaque of the cervical internal carotid artery is carotid endarterectomy ( CEA ), a procedure first described in the mid-1950s and used increasingly as a stroke prevention measure during the 1960s and 1970s . Jesse Thompson , MD , the founder of the vascular fellowship program on the Baylor Dallas campus , was especially known for his pioneering work in CEA .
CEA removes the inner lining of the carotid artery where plaque deposits are located , eliminating the source of a neurological event . Patients unable to undergo CEA for various medical reasons may benefit from another procedure , carotid angioplasty and stenting , to restore blood flow and cover the obstructing plaque . Vascular surgeons on the medical staff at Baylor Scott & White Heart and Vascular Hospital have been involved in years of research and clinical studies related to carotid stenting devices and techniques .
Transcarotid Artery Revascularization ( TCAR )
In keeping with the long-standing tradition of remaining on the forefront of treating patients with blockages in the carotid artery that could cause stroke , the surgeons on the medical staff are in a small group of vascular surgeons trained in a new approach called Transcarotid Artery Revascularization . TCAR , for short , is an endovascular technique to treat blockages in the carotid artery . Several of the vascular surgeons on the medical staff have been trained in this technique and are sought after for this new skill by others for proctoring .
In the TCAR procedure , a small incision is made just above the collarbone to expose the common carotid artery . A soft , flexible sheath is placed directly into the carotid artery and connected to a highly specialized system that will reverse the blood flow away from the brain . This blood flow reversal protects against fragments of plaque that may come loose during the procedure . The blood is filtered and returned through a second sheath placed in the femoral vein in the patient ’ s groin . A stent is then placed and the small incision is closed . Patients have been discharged from the hospital in typically less than two days , often within one day . It has been noted that TCAR combines safety and reliability of open carotid endarterectomy with the minimally invasive features of carotid stenting .
TCARs performed ( FY18 ) 32
TOP 20
Program in the U . S . by volume
Leaders in vascular surgery education , surgeons on the Dallas campus offer once a quarter video conferences to eight sites around the country . Special case studies are used to enhance other clinicians ’ knowledge on vascular surgery topics .
( FY18 )