Minimally-invasive procedure lowers stroke risk for heart patient

September 10, 2019 | by Edward-Elmhurst Health

Frank Kirby, 82, had never been a hospital patient before November 2018.

That fall, the Oak Brook resident had a heart attack and was treated in the Emergency Department at Elmhurst Hospital.

“I’d never spent a day in the hospital in my life. Never took a pill,” Kirby said.

Life changed dramatically for Kirby that November day.

As he was being treated for his heart attack, doctors noticed significant plaque blockage in Kirby’s carotid artery.

It’s a common problem, says Michael J. DaValle, M.D., a cardiovascular surgeon with Cardiac Surgery Associates, on staff at Elmhurst Hospital and Edward Hospital, chief of cardiac surgery at Elmhurst Hospital. It’s also a common cause of stroke.

“When patients have blockage and symptoms, they need to do something about it. If they have severe blockage and haven’t had a symptom, they need something done because a lot of times the first symptom will be a stroke,” says Dr. DaValle.


A carotid endarterectomy is the “gold standard” for removing plaque from the carotid artery, though it carries a higher risk for heart complications and nerve damage.

Trans-femoral carotid stenting is another way to open the artery, though it carries an increased risk of stroke. As the plaque is disturbed by the stent, bits of it can break off and follow the flow of blood to the brain.

A third option, transcarotid artery revascularization (TCAR), is a minimally-invasive procedure that allows for stenting of the carotid artery while a device reverses the blood flow and filters it back into the patient’s body through the femoral vein in the thigh, avoiding the risk of plaque traveling to the brain.

Once the stent is in place, the TCAR device is removed and blood flow returns to normal. With TCAR there is minimal risk of stroke, nerve damage or cardiac complications.

Patients who fall in a high surgical risk category are the best fit for TCAR, and Kirby was in that category because of his previous heart attack, DaValle says. Dr. DaValle performed Kirby’s TCAR procedure with cardiologist Pratik Parikh, M.D.

After the TCAR procedure, patients are usually able to go home the next day and get back to their normal activities in about one week. A few months later, doctors check the artery and, if all is well, they check it again in a year.

“We were the third center in Illinois to do this, and the outcomes from the studies are showing excellent early and long term results,” DaValle says.

Meanwhile, Kirby has gotten back to his pre-hospital routine.

“I feel great,” he says. “I’ve got a farm, I work hard at the farm. I can do everything.

“I haven’t had any pain at all. I was happy with the whole procedure, I’ve had no problems with it.”

Your heart is in expert hands when you choose Edward-Elmhurst Heart Hospital for your cardiovascular care. Because for us, this is personal.

Learn more about the comprehensive heart care services at Edward-Elmhurst Heart Hospital.

Learn more from Healthy Driven Chicago:

Helping men prevent heart disease

New technology improves heart disease screenings and treatment

Five cardiac risk factors you need to know

Five way to prevent a heart attack

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