“So T.C.A.R, TCAR is a surgical procedure. It stands for Transcarotid Arterial Revascularization, and it’s a procedure that’s in our toolbox for treatment of patients with Carotid Occlusive Disease, that may be high risk for stroke.”, says Dr. Russell Wood, a Cardiovascular Surgeon with the Walker Heart Institute. “So, the TCAR procedure is done under general anesthesia. The artery in the neck is accessed through a small one- or two-centimeter incision at the base of the neck. We then directly cannulate the artery or place a catheter inside the artery itself, and then we establish reverse flow in that vessel, and that allows us to prevent any risk of blood clots going to the brain and causing strokes during the procedure. Once we establish the reverse flow in the artery, then we can place a wire across the block segment, and then stent it just like we would with a standard carotid artery stenting. So typically, these patients are considered to be higher risk for surgery, also patients that are not good candidates for transfemoral carotid stenting through the groin artery. So as opposed to carotid endarterectomy, which is a more invasive surgical procedure, and carotid artery stenting, which is, requires access to an artery in the groin, this procedure offers direct access to the artery in the neck, and the highest chances of success with the lowest risks of complications of death, stroke, and light strokes. So this procedure is done under general anesthesia, but most patients don’t have any pain from this surgery at all and don’t require any type of pain medicine afterwards. They are monitored in the neurointensive care unit over night, but most patients go home the next day, and there are no restrictions on their activities afterwards.”