Transcarotid Artery Revascularization (TCAR) | MedStar Health

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Transcarotid Artery Revascularization (TCAR) is a minimally invasive procedure used to treat carotid artery disease and to prevent strokes. During TCAR, blood flow is temporarily reversed so any plaque that is dislodged is diverted away from the brain. TCAR is an option for older patients who have other medical conditions that make open carotid surgery, such as carotid endarterectomy, a high-risk procedure.

What to expect during transcarotid artery revascularization (TCAR)

TCAR procedure is performed in a hospital operating room. You may be asked not to eat or drink before the procedure. Ask your doctor if you should take your regular medications. Your doctor will discuss sedation options before the procedure, which may include local anesthesia (the neck area is numbed, and you will be awake) or general anesthesia (you will be asleep with a breathing tube inserted).

Your surgeon will make a small incision in your neck just above the collarbone. A tube is inserted into the carotid artery and is connected to a device that filters the blood for any bits of plaque, and after the filter, the tube connects to the femoral artery in the leg. The filter prevents the risk of stroke during the procedure. A wire is inserted in the narrowing of the artery and a balloon is used to open the blockage. A stent is then inserted to keep the artery open and hold the blockage in place. Once the stent is in place, the tubing and filter are removed and the incision in the neck is closed. The TCAR procedure takes between one and a half to two hours.

While the procedure is underway, blood flows to your brain from the opposite side carotid artery and the vertebral arteries at the back of the brain.

Conditions

  • Carotid artery disease: Tricuspid stenosis is a narrowing of the heart’s tricuspid valve, which limits the flow of blood through the heart.

  • Angiogram (Angiography): An angiogram is a special X-ray taken as a special dye that is injected through a thin, flexible tube called a catheter to detect blockages or aneurysms in blood vessels.

  • Carotid Duplex Ultrasound: Carotid duplex ultrasound uses Doppler and traditional ultrasound to assess blood flow in the arteries that supply blood to your brain.

     

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MedStar Union Memorial Hospital

201 E. University Pkwy.
Baltimore, MD 21218

MedStar Washington Hospital Center

110 Irving St. NW
Washington, DC 20010

MedStar Southern Maryland Hospital Center

7503 Surratts Rd.
Clinton, MD 20735

MedStar Georgetown University Hospital

3800 Reservoir Rd. NW
Washington, DC, 20007

MedStar Franklin Square Medical Center

9000 Franklin Square Dr.
Baltimore, MD 21237

MedStar Harbor Hospital

3001 S. Hanover St.
Baltimore, MD 21225

MedStar Good Samaritan Hospital

5601 Loch Raven Blvd.
Baltimore, MD 21239