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Carotid artery stenting made safer at Geisinger

Rob Brown is happy to be a beneficiary of cutting- edge, minimally invasive vascular surgery available at Geisinger.

Julian resident Rob Brown, 77, needed surgery to open up a narrowing in his carotid artery. A local hospital discovered the blockage after treating him for a minor stroke. 

The hospital referred Mr. Brown to Geisinger, which offers an advanced procedure called transcarotid artery revascularization (TCAR). Vascular surgeon Jeremy Irvan, MD, took it from there. 

Less invasive, easier stent recovery

TCAR is a stenting procedure, but it offers a key advantage over traditional stenting by reversing blood flow to the plaque blockage. That decreases the risk of a piece of plaque breaking off and causing a stroke during the procedure.

Dr. Irvan made a small incision near Mr. Brown’s collarbone to place the stent, using only local anesthetic. And because Mr. Brown chose to be awake during the procedure, he recovered very quickly.

“He was a candidate to do this under local anesthesia,” Dr. Irvan says. “His recovery was much easier because of that. When the procedure was over and I met him in the recovery room, he looked as if he hadn’t had a surgery at all. He had a remarkable recovery and a great outcome.”

A retired social studies teacher, Mr. Brown was pleasantly surprised that he didn’t have to go under general anesthesia. 

“As soon as the procedure was finished, I was done and ready to go,” he says. “The recovery was so easy. The care I received was top of the line.”

Advanced vascular surgery in Pennsylvania

Geisinger began offering TCAR surgery to qualifying patients in 2018.

“The TCAR procedure is a new way to deploy a carotid stent for someone who has carotid narrowing and a risk for stroke,” Dr. Irvan says.

The “gold standard” open surgery to remove plaque from the carotid artery is known as endarterectomy. However, says Dr. Irvan, “Studies have shown TCAR is approaching equivalent outcomes with endarterectomy. That’s profound.”

Geisinger is the only hospital system in the region with the facilities and expertise to provide TCAR — and Mr. Brown was happy to take advantage of it. His wife Linda has high praise for the surgeon, too.

“Dr. Irvan took his time with us to make sure everything was clear, and that we were comfortable with the information he shared,” she says. “We had the most wonderful, positive experience at the hospital.”

Next steps:

Read and watch more stories
Learn about vascular surgery at Geisinger
See how Geisinger vascular surgeons helped another complex case
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