One lucky eye exam

May 19, 2023

Providence Heart & Vascular Team

This story was originally published in the Fall/Winter 2022 edition of Providence Holy Cross Medical Center Health Matters.

[3 MIN READ]

Providence Holy Cross Medical Center detects stroke prevention for healthy aging through TCAR, a leading-edge treatment for blocked carotid arteries.
Dr. Sammy Eghbalieh and Dr. Adi Iyer were thoughtful in their treatment plan to ensure their patient, Nancy Brown, could maintain her active lifestyle post-surgery.
Be proactive with your health and make the appointment for your annual screenings. It could save your life.

When a routine eye exam showed Nancy Brown had suffered two small strokes, she was reminded of the time her father had a stroke. The Santa Clarita woman, now 88, remembered nurses talking about her father and the pros and cons of surgery to prevent future strokes. After her diagnosis, she decided to have the affected carotid artery screened.

“We learned she had severe carotid artery blockage — more than 70%,” says Sammy Eghbalieh, MD, a vascular and endovascular surgeon at Providence Holy Cross Medical Center. Dr. Eghbalieh wanted to ensure his patient could maintain her active lifestyle and offered transcarotid artery revascularization (TCAR) as a surgical option. He explains, “She got cleared for TCAR surgery by the cardiologist.” And the surgery was a resounding success.

Brown’s case is a powerful illustration of the importance of stroke prevention for healthy aging. Providence Holy Cross Medical Center, a leading stroke care center in Los Angeles, offers a comprehensive stroke prevention program that includes TCAR technology, a minimally invasive surgical technique that makes it safer than ever to clear carotid artery blockages that can lead to stroke.

Brown’s surgery, accomplished with just a two- centimeter incision, was successful. She spent the night in the hospital to be monitored, and by the next morning she was already eating regular food and was discharged without pain.

“With TCAR it is safer than ever to clear carotid artery blockages in patients like Nancy. It is changing the game in treating carotid artery disease,” says Dr. Eghbalieh.

Traditional surgery for carotid artery blockage can be too risky to perform on older patients and patients with other medical issues.

Two weeks after surgery, “I was back to normal,” says Brown. She resumed all her normal activities the next day — except afternoon gardening due to the August heat. “I haven’t had any problems whatsoever. I still drive; I even dry my own hair. I like to garden in the evening when it cools down,” she says.

The patient’s needs come first

Traditional surgery involves much higher risks of cranial nerve injury and stroke, and more medication to manage the pain than with TCAR.

“The procedure redirects blood flow away from the brain as the carotid artery is being cleared, so debris doesn’t flow into the brain,” says Adi Iyer, MD, a neurosurgeon with Providence Holy Cross Medical Center. With TCAR, patients have little pain and no significant downtime.

TCAR may be utilized soon to repair stroke and other brain maladies. “Direct transcarotid access is key,” explains Dr. Iyer. “It opens up possibilities of doing all kinds of brain interventions. It’s become a safe option for emergency brain surgeries, too, as it provides quick access, with less risk.”

Get checked

Experts advise having a physical every year to get blood pressure and cholesterol checked. If heart disease or stroke runs in your family, request a carotid artery screening.

“I’m back to normal and today went out shopping,” Brown says.

“I really hope my story can help others. I didn’t want to endure a larger stroke that could be debilitating. This procedure was easy, and I’m so glad it was done!”

Contributing Caregivers

Sammy D.D. Eghbalieh, M.D. is a board-certified expert in the most advanced techniques of vascular, endovascular, and minimally invasive surgery for venous and arterial diseases at Providence.

Adi K. Iyer, M.D. is a fellowship-trained neurosurgeon with a focus on vascular diseases of the brain and spine at Pacific Neuroscience Institute.

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