by: Washington Regional Medical Center
“So TCAR, TCAR is surgery. This stands for Transcarotid Arterial Revascularization, and it is a procedure that is part of our toolkit for treating patients with carotid occlusive disease, who may be at high risk for stroke,” says Dr. Russell Wood , a cardiovascular surgeon at the Walker Heart Institute. “So the TCAR procedure is done under general anesthesia. The neck artery is accessible through a small incision of one or two centimeters at the base of the neck. We then directly cannulate the artery or place a catheter inside the artery itself and then establish reverse flow through that vessel, allowing us to avoid any risk of blood clots going to the brain and causing strokes during the procedure. Once we have established reverse flow in the artery, we can place a wire through the block segment and then stent it as we would standard carotid artery stenting. So generally these patients are considered to be at higher risk for surgery, also patients who are not good candidates for placement of a transfemoral carotid stent through the inguinal artery. Thus, unlike carotid endarterectomy, which is a more invasive surgical procedure, and carotid artery stenting, which requires access to an artery in the groin, this procedure provides direct access to the artery in the neck and the best chance of success. with the lowest risks of complications of death, stroke and mild stroke. So, this procedure is done under general anesthesia, but most patients do not feel any pain from this surgery and do not need any type of painkiller afterwards. They are monitored in the neuro-intensive care unit overnight, but most patients go home the next day and there are no restrictions on their activities afterwards.