Hackensack University Medical Center Becomes Only Hospital in New Jersey to Offer Transcarotid Artery Revascularization (TCAR) Clinical Trial

Study to assess real-world outcomes for patients treated with minimally invasive TCAR procedure

Hackensack University Medical Center is the only site in New Jersey that is participating in the ROADSTER 3 clinical trial to assess real-world outcomes for patients with carotid artery disease who have an average surgical risk and undergo a minimally invasive surgical procedure called transcarotid artery revascularization (TCAR).

TCAR is a minimally invasive procedure that allows vascular surgeons to more safely treat blockages caused by plaque inside the carotid arteries, which are located on either side of the neck and supply blood to the brain. Blockages in the carotid artery are associated with an increased risk of stroke, and are responsible for a third of all strokes in the U.S. 

During TCAR, surgeons access the carotid artery through a small incision in the patient’s neck just above the collarbone and insert a specialized sheath to deliver a stent that unblocks the  carotid artery. The sheath temporarily reverses blood flow in the carotid artery so that it travels away from the brain, preventing small pieces of plaque that may break off during the procedure from moving to the brain where they could cause a stroke.

A Safer Alternative to Traditional Carotid Artery Revascularization Procedures

TCAR is an alternative to an open procedure called a carotid endarterectomy and another minimally invasive procedure called transfemoral filter-protected stenting, both of which can carry a higher risk of stroke than the TCAR procedure. In addition to reducing the risk of a procedural stroke, another benefit is that TCAR is typically performed through a small incision near the treatment site using local anesthesia and light sedation — making it an ideal option for patients who may be at high risk of complications related to general anesthesia or a more invasive procedure.

“Initially, TCAR was only approved for patients with carotid artery disease who were at high risk of experiencing surgical complications due to age, other medical conditions, or complex anatomy — and TCAR has delivered excellent outcomes in those patients,” said David O’Connor, M.D., FACS, Director of Vascular Research at Hackensack University Medical Center and Assistant Professor of Surgery at Hackensack Meridian School of Medicine. “Through the ROADSTER 3 trial, we are looking at the benefits of TCAR for patients with a standard surgical risk with the goal of expanding our ability to offer this procedure to a majority of patients with carotid artery disease.”

Nationally Recognized for TCAR Experience and Excellence

Under Dr. O’Connor’s leadership, Hackensack University Medical Center is the highest-volume TCAR center in New Jersey and among the highest-volume centers in the region. Additionally, Hackensack University Medical Center has been named a TCAR Center of Excellence by Silk Road Medical, the company that developed the TCAR procedure. 

Hackensack Meridian Health was one of the first health networks in New Jersey to offer TCAR, performing more than 100 TCAR procedures since the technique and technology became available in 2017. As a result, Hackensack Meridian Health vascular surgeons are among the most experienced in the region at performing TCAR and receive prestigious invitations to participate in groundbreaking prospective national multi-center clinical trials such as ROADSTER 3.

Dr. O’Connor has also published research on TCAR and has served as a proctor for the TCAR procedure, providing TCAR training to vascular surgeons across the nation.

Dr. O’Connor and his team at Hackensack University Medical Center were recently featured in a segment on News 12 New Jersey highlighting the hospital’s 100th TCAR milestone. The team hopes that this coverage will raise awareness about minimally invasive treatment options for carotid artery disease.

“Patients who are at risk for other types of heart disease due to smoking, high cholesterol, high blood pressure, diabetes, and a personal or family history of heart disease, should also be screened for carotid artery disease,” said Dr. O’Connor. “We want people in our communities to know that safe treatment is available for carotid artery disease that can reduce stroke risk.”