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Transcarotid Artery Revascularization (TCAR)

TCAR is a minimally invasive procedure that clears blockages and opens a narrowed carotid artery. The surgeon makes an incision over the common carotid artery to perform the repair. During the TCAR procedure, the surgical team reverses blood flow in the area of the blockage.

Compared to carotid endarterectomy (CEA), a surgical carotid treatment, features of TCA include:

  • Less Time in Operating Room
  • Less Myocardial Infarction
  • Less Cranial Nerve Injury 
  • Less Time in the Hospital > 1 Day
  • Less Clamp Time

Who Is Eligible

TCAR is well-suited for patients who are at high risk of surgical complications due to age, medical co-morbidities, or anatomical issues. This includes:

  • Symptomatic patients with > 50% stenosis
  • Asymptomatic patients with > 80% stenosis

Safe and Simple Procedure 

The transcarotid artery revascularization (TCAR) procedure takes place at the Summa Health System – Akron Campus. It begins with a small incision just above the collarbone. A temporary sheath (short hollow tube) is placed directly into the carotid artery in an area away from the diseased area (plaque). The sheath connects to a filter outside of the body. The filter connects to another small sheath and, through a needle puncture in the groin, is placed directly into the vein, similar to an IV. 

The difference in pressure causes the blood to flow in reverse from the artery (high flow), through the filter, and into the vein (low flow), away from the brain. This establishes a circuit outside of the body. A stent (an expandable mesh tube) is then inserted through the arterial sheath to open the blocked artery. Because of the blood flow reversal, any debris that might break loose during stent placement won’t travel up to the brain. Rather, it travels downward and gets trapped in the filter, and the filtered blood returns into the vein.

Post-Procedure

Most patients are able to go home the day after the procedure. They should follow their TCAR physician’s instructions for taking care of the incision and while they may experience some pain, it should be minimal. 

To learn more about TCAR or other cardiac care procedures, contact the Summa Health Heart and Vascular Institute for an appointment at 330.535.9555.

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