A decade after first identifying its potential, vascular surgeon Dr Bernie Bourke has imported a technique for carotid revascularisation — at a time when the clinical landscape around asymptomatic carotid disease is shifting once more.

Together with his son, Dr Victor Bourke, he is among the first surgeons in Australia accredited to perform transcarotid artery revascularisation (TCAR).

It is a hybrid procedure commonly used in the US that allows surgeons to place a stent directly into the carotid artery through a small incision above the clavicle.

A special tubing device shunts blood flow away from the brain into a filter and back through the groin, with the aim of significantly reducing the risk of debris and stroke.