Delray Medical Center First South Florida Hospital To Offer TCAR Procedure For Carotid Artery Disease

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By: David DiPino Contributing Writer

Something out of the ordinary during an eye exam led Simon Williams to Dr. Joseph Ricotta and one of the first TransCarotid Artery Revascularization (TCAR) surgeries in South Florida.

Williams went to his optometrist when he noticed a small blind spot had developed in his eye. The optometrist observed little bits of plaque in Williams’ eye and suggested he see a specialist. Plaque in Williams’ right carotid artery was breaking off and dangerously traveling toward his brain.

“By just looking into my eyes the optometrist could see plaque in there,” Williams said.

Plaque building up in arteries can obstruct necessary blood flow to the brain.

Prior to meeting Dr. Ricotta, Williams was told he needed a carotid endarterectomy, a surgery used to open up carotid artery blockages in the neck. The procedure can help to prevent a stroke.

“I had squamous cell carcinoma cancer on the base of my tongue 11-years prior. Chemotherapy and radiation damaged structures in my neck so I wasn’t a candidate for an endarterectomy,” Williams said.

He needed a stent put in his right carotid artery to open up the blood flow to his brain, so he began looking for alternatives. Williams turned to his faith and friends.

“Because I’m a Jehovah’s Witnesses I wanted a procedure that wouldn’t involve much blood loss. I called a friend who works in a doctor’s office and they recommended Dr. Ricotta as the best in Florida. I made an appointment with Dr. Ricotta and he said yes I was a candidate for the TCAR procedure,” Williams said.

Dr. Ricotta saw Williams at his Tenet Florida Cardiovascular Care office in Delray Beach and during a carotid artery ultrasound confirmed the blockage.

Williams’ right carotid artery was 95 percent blocked. Just five weeks after the plaque was first noticed in Williams’ eyes, Dr. Ricotta performed the first TCAR procedure on the east coast of Florida. Williams’ TCAR was performed in the new Endovascular Hybrid Operating Room at Delray Medical Center.

To start the TCAR procedure, Dr. Ricotta placed a small incision above Williams’ clavicle to access his right carotid artery. Next, a pliable sheath was placed into the carotid artery. Blood flow was reversed away from his brain to minimize plaque debris from travelling to the brain. His blood was filtered and returned to his body via another sheath in the femoral vein of his thigh. Next, Dr. Ricotta put a neuroprotection system in place, performed a balloon angioplasty and placed a stent in the artery. Once the stent was in place, Dr. Ricotta turned off the reversal flow mechanism and returned blood flow to Williams’s brain. The filter caught the plaque that can cause a stroke.

“Dr. Ricotta showed my wife the before and after ultrasounds of my right carotid artery when it was blocked and afterward completely open. My wife took a picture of the before and after of the ultrasound and it’s been a very effective tool to explain the importance and value of this type of surgery. My wife and son were very happy with Dr. Ricotta and the results of his surgery,” Williams said.

“I had the procedure and was out of the hospital the next day. Dr. Ricotta performed the surgery on a Thursday and the following Monday I was back to work. Knowing the carotid artery is unclogged has increased my self-confidence. I feel great!” Williams said.