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; it is estimated to be the source of stroke in up to a third of cases, with 427,000 new diagnoses of the disease made every year in the U.S. alone.

“Patients who fall into a high-risk category should not have to choose between treatment and quality of life. TCAR offers a safe, effective alternative to traditional treatments for carotid artery disease,” says Alexander Uribe, MD, Chief of Vascular Surgery at Main Line Health. “To be among the first in our region to offer this treatment as an option for high-risk patients is another testament to Main Line Health’s reputation for excellent stroke care and intervention.” The Lankenau Heart Institute team of vascular specialists who use minimally invasive approaches such as TCAR and provide a full range of vascular care include Henry Hirsch, MD, Robert Meisner, MD, and Vincent DiGiovanni, DO.

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). Unlike TCAR, CEA requires a large incision, leaves a visible scar the length of the neck and 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.

The TCAR procedure 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. TCAR has been studied extensively and is an FDA-cleared procedure. Over 25,000 procedures have been performed worldwide, and the clinical data have been excellent. Based on published clinical trials, the procedure offers several advantages, including better outcomes and a quicker recovery.

The Lankenau Heart Institute is Main Line Health's premier comprehensive cardiovascular medicine and surgery program. Lankenau Heart Institute brings together the clinical expertise of all four Main Line Health acute care hospitals and both the employed and community cardiology practices to ensure that patients receive a level of quality, service and experience that is unparalleled in the region. Through the systemwide coordination of services, Lankenau Heart Institute delivers preventive, diagnostic, therapeutic and rehabilitative cardiovascular services at each of our locations including Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital.

Lankenau Heart Institute continues to be an innovator in the use of beating-heart techniques and robotic-assisted procedures for coronary artery revascularization, minimally invasive and transcatheter approaches for valve repair and replacement, complex aortic surgery and heart rhythm disorders. With our growing experience and focus on minimally invasive techniques, Lankenau Heart Institute has expanded participation in clinical trials year after year. Our physicians are frequently invited to participate in clinical/medical device trials, many of which are designed to facilitate the use of minimally invasive approaches and procedures.

With a collaborative team of expert consultative cardiologists, interventional cardiologists, electrophysiologists, cardiovascular surgeons and specially trained advance practice nurses and technologists, Lankenau Heart Institute is dedicated to managing and treating patients with simple to complex cardiovascular disease, including heart failure, aortic disease, coronary and peripheral vascular disease, lipid and genetic abnormalities, heart rhythm disorders and valve disease. Our team of cardiologists and cardiac and vascular specialists provide patients and their families with expert cardiovascular care, close to home.

Lankenau Medical Center, part of Main Line Health, has been devoted to the health and well-being of the community since 1860, with a founding mission to serve all those in need. Our continued dedication to service, compassionate patient care and superior clinical programs makes Lankenau a preferred destination for care by people throughout the Philadelphia region and beyond. Lankenau offers primary care, disease prevention and specialized medical and surgical management of all diseases and disorders, as well as access to clinical trials. As a 371-bed teaching and research institution, Lankenau is committed to maintaining high-level expertise across all clinical areas and is consistently recognized for providing outstanding care across major specialties including heart and vascular care, cancer care, obstetrics and gynecology, orthopaedics, gastroenterology, pulmonology, neurosurgery, nephrology and urology. Lankenau is ranked as one of the top three hospitals in the region and top seven in the state by U.S. News & World Report 2023-24. It is rated a high performer in the Centers for Medicare and Medicaid Services' Overall Hospital Quality Star Rating.

Founded in 1985, Main Line Health is a not-for-profit health system serving Philadelphia and its suburbs. Main Line Health's commitment — to deliver safe, high-quality, equitable and affordable care for treating and curing disease, playing an important role in prevention and disease management, as well as training physicians and other health care providers — reflects our intent to be the region's premier choice for clinical care, research, and education. A team of more than 13,000 employees and over 3,500 employed and independent physicians and advanced practice providers care for patients throughout Main Line Health.

At Main Line Health's core are four of the region's most respected acute care hospitals — Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital — as well as one of the nation's premier facilities for rehabilitative medicine, Bryn Mawr Rehab Hospital.

Main Line Health also includes Mirmont Treatment Center for drug and alcohol recovery; Main Line Health HomeCare & Hospice, which includes skilled home health care, hospice and home infusion services; Main Line Health Centers, primary and specialty care, lab and radiology, and other outpatient services located in Broomall, Collegeville, Concordville, Exton, King of Prussia and Newtown Square; Lankenau Institute for Medical Research, a biomedical research organization; and Main Line HealthCare, one of the region's largest multispecialty physician networks.

Main Line Health is the recipient of numerous awards for quality care and service, including the prestigious American Hospital Association Quest for Quality Prize, highest tier ratings from the Centers for Medicare & Medicaid Services (CMS) for Overall Hospital Quality and systemwide recognition in the 2023-2024 U.S. News & World Report Best Hospitals rankings. Main Line Health is committed to creating an environment of diversity, respect, equity and inclusion, has proudly received awards in this area and has embraced the American Hospital Association's #123forEquity Pledge to Act to eliminate disparities in care. We are dedicated to advancing patient-centered care, education and research to help patients stay healthy and live their best lives.

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