Minimally Invasive Treatment for Carotid Artery Disease Reduces Stroke Risk

**By Nathan Aranson, MD**


Nathan Aranson, MD

Virginia Mason is among the first medical centers in the United States to offer patients a minimally invasive procedure called transcarotid artery revascularization (TCAR) to treat carotid artery disease and decrease the risk for stroke.

The carotid arteries supply oxygen-rich blood to the brain. If these arteries become blocked by plaque, the individual’s risk for stroke increases because the plaque can break up and flow to the brain. More than 300,000 people are diagnosed with carotid artery disease every year.

The traditional treatment for carotid artery disease involves an open surgery called carotid endarterectomy (CEA). This treatment is effective in decreasing the risk of stroke, but it carries risks, including nerve injury near the large incision site. According to a study published in the Journal of Vascular Surgery, TCAR demonstrated a low (1.4 percent) 30-day stroke rate, comparable to results seen with CEA, but with a lower incidence of surgical complications.

During the TCAR procedure, a small incision is made above the patient’s collarbone to gain access to the blocked carotid artery. Blood flow is also temporarily reversed in the carotid artery to divert dangerous debris away from the brain, preventing a stroke during the procedure. A stent is then implanted in the carotid artery to clear the plaque buildup and reduce the risk for stroke in the future. This innovative procedure, performed under local anesthesia, minimizes nerve injury, reduces scarring and speeds the patient’s recovery.

Carotid artery disease is a major cause of stroke, a leading cause of death and life-altering disability in the United States. Frequently there are no symptoms until a person has a transient ischemic attack (TIA, or “warning stroke” that causes no permanent damage) or full-blown stroke. Talk with your doctor about your risk for carotid artery disease, or call the Virginia Mason Stroke Center at (206) 341-0420.

With the TCAR procedure, we are pleased to provide patients with a less invasive treatment for carotid artery disease, helping them return to full and productive lives.

Nathan Aranson, MD, specializes in vascular and endovascular surgery, varicose vein treatment and wound care at Virginia Mason. He is certified by the American Board of Surgery.


  1. A percutaneously place carotid stent is faster and safer

  2. Carol Wendler says:

    Is this procedure done when 50% of artery is blocked? Family member who is 68 has this type of blockage and has significant memory loss. Please advise.

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