Mildred’s Story

85-year-young Mildred Brown

Leading-edge Lady: Innovative Procedure to Prevent Stroke Helps 85-Year-Young Woman Retain her Independence

Mildred Brown, 85, of Brunswick, maintains an active, independent lifestyle. When carotid artery disease significantly increased her risk for stroke, University Hospitals Harrington Heart & Vascular Institute physicians utilized an innovative procedure to help keep Mildred living the life she enjoys.

What is Carotid Artery Disease?

The human body has two carotid arteries – one on each side of the neck – that supply oxygen-rich blood to the brain. Carotid artery disease occurs when plaque builds up in the arteries, blocking blood flow and potentially causing a stroke.

Jeffrey Boyko, DO, a vascular surgeon at UH Parma Medical Center, has been treating Mildred for several years for carotid artery disease. She previously underwent carotid endarterectomy (CEA), which entailed him making a cut in her neck to remove the plaque build-up. While the CEA was successful, when plaque build-up returned, scar tissue that developed made repeating the CEA procedure on Mildred a higher risk.

TCAR: A Minimally Invasive, Innovative Procedure

That’s when Dr. Boyko referred Mildred to Vikram Kashyap, MD, FACS, Chief, Division of Vascular Surgery and Endovascular Therapy and Co-Director, Vascular Center, UH Harrington Heart & Vascular Institute. Dr. Kashyap is one of the country’s foremost experts on Transcarotid Artery Revascularization (TCAR).

TCAR offers patients the benefits of a minimally invasive procedure with a reduced risk of stroke compared to other approaches. With TCAR, a stent is inserted into the carotid artery to restore blood flow, but using a system by Silk Road Medical, blood flow is reversed during the stenting process. Blood is sent away from the brain and filtered, thereby reducing stroke risk from fragments of plaque that may come loose.

TCAR was approved by the Federal Drug Administration (FDA) in 2015, and Dr. Kashyap has been performing the procedure at UH Cleveland Medical Center since 2013 via clinical trials. He routinely participates in important research regarding TCAR and three respected medical journals have published papers since July 2019 in which his findings are included.

Quick, Safe and Painless

“Dr. Kashyap explained the procedure to me in a way I could understand,” said Mildred, whose son and daughter-in-law were by her side at UH Cleveland Medical Center. “I was only in the hospital for one night, and I felt no pain whatsoever.” She continued, saying, “Everyone I encountered – my doctor, nurses – were so nice. They made me feel so comfortable and they took good care of me.”

“One of the great advantages of having an integrated system is that patients can get most of their care locally, yet benefit from innovations that are only available in certain academic medical centers, often by participating in a clinical trial,” says Dr. Kashyap.

Mildred returned home, and upon her one-year follow-up with Dr. Kashyap, she reported no after effects from the procedure. “I feel great, and I hope by sharing my story that I’ll help others to not be afraid.”