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Carotid Artery Procedures

Carotid Endarterectomy

Carotid Artery Procedures

When peripheral artery disease (or P.A.D.) 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 treatment option to resolve this condition is a surgical procedure called carotid endarterectomy. In this procedure the physician makes an incision on the front of the patient’s neck, opens the carotid artery and removes any blockages, and then stitches the artery closed. This surgery may be performed following a stroke and can also help prevent strokes.


Paul Lockman is a world-traveler who learned he had blockage inside his carotid artery. A carotid endarterectomy allowed him to continue his philanthropic travels. Read his carotid endarterectomy testimonial.

Carotid Stenting

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

As part of a minimally-invasive procedure known as coronary angioplasty, the physician will make a small incision in the patient’s groin, arm or neck, then insert 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 Hamilton Heart and Vascular Hospital 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 Hamilton Heart and Vascular Hospital 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, also known as TCAR for short, combines the safety and reliability of open carotid endarterectomy with the minimally invasive features of carotid stenting.

Often performed under local anesthesia, a small incision is made just above a patient’s collar bone to expose the common carotid artery in the TCAR procedure. Then a soft, flexible sheath is placed directly into the carotid artery, connected to a specialized system to reverse the flow of blood away from the brain to protect 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 thigh, and then the stent — a small wire mesh coil —is inserted and placed to open the artery.



Vascular surgeons on the medical staff at Baylor Jack and Jane Hamilton Heart and Vascular Hospital continue a long history and tradition of innovation with the TCAR (Transcarotid Arterial Revascularization) procedure, often an alternative to carotid endarterectomy.

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