South Florida Hospital News
Friday December 13, 2019

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August 2018 - Volume 15 - Issue 2




Delray Beach Doctor Performs First TCAR on the East Coast Of Florida

Dr. Joseph Ricotta, a vascular surgeon and endovascular therapy specialist at Tenet Florida Cardiovascular Care (TFCC), recently performed one of the first TransCarotid Artery Revascularization (TCAR) surgeries in the State of Florida at Delray Medical Center’s new Endovascular Hybrid Operating Room Suite. Dr. Ricotta begins the TCAR procedure with a small incision above the clavicle to access the patient’s carotid artery. Then, Dr. Ricotta inserts a pliable sheath into the carotid artery and links it to a component which reverses blood flow away from the brain in an effort to avert, by use of filter, any clot forming plaque from traveling to the patient’s brain system. During the TCAR, Dr. Ricotta and his team filter the blood and then return it to the body via an additional sheath in the femoral vein of the patient’s thigh.

As the TCAR procedure progresses and blood flow continues to be reversed, Dr. Ricotta uses a neuroprotection system during the TCAR to perform a balloon angioplasty and stenting, to open blood flow in veins. Once Dr. Ricotta places the stent in the artery to eliminate the plaque from the carotid artery, the reversal flow mechanism is turned off and blood flows freely to the brain into its intended path free from stroke inducing plaque.
“Before the development of the TCAR procedure the treatment options presented challenges of their own. The previous option, a carotid endarterectomy is quite invasive and can lead to complications in patients at risk for an open surgical procedure,” Dr. Ricotta said.
The TCAR procedure can be another option available for high surgical risk patients needing a carotid endarterectomy. The TCAR procedure gives vascular surgeons, like Dr. Ricotta, an alternative tool in their toolbox to clear harmful plaque from the carotid artery which could cause stroke. 
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