When is TCAR used?

TCAR is typically used to treat carotid artery disease as an alternative to carotid endarterectomy (CEA), a major surgical procedure involving removing plaque from the carotid artery through a large incision in the neck. While effective, CEA comes with significant risks, including nerve injury, heart attack, and bleeding. TCAR offers a safer, less invasive option for patients, especially those at high surgical risk.

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Am I a candidate for TCAR?

If you've been diagnosed with carotid artery disease, TCAR could be a potential treatment option for you. It's particularly beneficial for patients at high risk for traditional surgical procedures due to age, anatomy, or other medical conditions.

The TCAR procedure is ideal for patients who are acutely symptomatic or have certain considerations with their medical history. These considerations include recurrent lesions after carotid endarterectomy (CEA), high-grade lesions, or previous head and neck surgery or radiation treatment. Additionally, to be a good candidate for TCAR, you'll need to meet certain requirements for your vessel size and disease. No EEG monitoring is necessary, but you'll need to take Plavix for a period of time both before and after the procedure.

However, like all medical procedures, we will ensure you understand the procedures and any risks. Our team at Surgical Associates is highly trained and experienced in performing TCAR procedures, ensuring our patients receive the highest standard of care. We are committed to patient care and continually pursue the latest advancements in medical technology, including offering TCAR as a treatment option. Contact us today to schedule a consultation and learn more about how TCAR could benefit you.

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How is TCAR performed?

During a TCAR procedure, our surgeons make a small incision just above the clavicle to access the carotid artery. A tube is then inserted into the artery and connected to a system that temporarily redirects blood flow away from the brain. This protects against dangerous plaque fragments dislodging during the procedure. The blood is filtered and returned through a second tube in the patient's femoral vein, while any blockages in the carotid artery are stented to stabilize the plaque and prevent future strokes. The procedure is performed under general anesthesia, resulting in less pain, less scarring, and a quicker recovery time compared to traditional surgery.

The TCAR procedure what to expect

Undergoing a Transcarotid artery revascularization (TCAR) procedure involves several steps. The procedure is performed in an operating room at the hospital by a team that includes a vascular surgeon, nurses, technicians, and an anesthesiologist. Here's what you can expect:


Typically, general anesthesia is administered for the TCAR procedure, meaning that you'll be peacefully asleep throughout the surgery.


Your surgeon makes a small incision above your collarbone (clavicle) or a vertical incision over your common carotid artery.

Blood Flow Reversal and Return

The surgeon inserts a tube into your carotid artery and connects it to an advanced system that temporarily reverses blood flow. This ensures any loose fragments of plaque are caught and removed before they cause a problem. The filtered blood then returns to your body through a tube (catheter) inserted into a vein in your groin.

Stent Placement

The surgeon places a stent (a small wire mesh tube) in your carotid artery. The stent stays in place to hold open the carotid artery.

Wound Closure

Your surgeon removes the surgical tube, restores the direction of blood flow, and closes the incision with stitches.

TCAR recovery

Most people go home the day after a TCAR procedure. You should expect to take it easy for at least a week before returning to your usual activities. Your doctor will likely recommend taking aspirin and another drug to prevent blood clots, as well as a statin. These medicines help reduce long-term complications like stroke and heart attack. During your recovery, your doctor will order a carotid duplex ultrasound to check for carotid artery stenosis or narrowing. This test, which uses sound waves to show how blood is flowing through the artery, can be performed at our vascular testing and diagnosis lab.

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Why choose us for TCAR?

At our clinic, we prioritize patient comfort and recovery by utilizing minimally invasive techniques. Our experienced staff works closely with medical suppliers to leverage the latest technology while providing individualized care with a personal touch. With our focus on patient education and our commitment to listening to your concerns, you can be confident in choosing Surgical Associates for your TCAR procedure.

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