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TCAR Procedure for Carotid Artery Disease

Carotid artery disease is a form of atherosclerosis, or a build-up of plaque in the two main arteries of the neck which supply oxygen-rich blood to the brain. When plaque builds up in the carotid arteries, they begin to narrow and slow down blood flow, potentially causing a stroke if blood flow stops or plaque fragments travel to the brain. Carotid artery disease is one of the leading causes of stroke.

Washington Regional’s Walker Heart Institute was the first in Northwest Arkansas to offer transcarotid artery revascularization, or TCAR, a procedure that is used to treat carotid artery disease in patients with a high risk of stroke.

“The TCAR procedure as an alternative has a much lower risk of stroke and a much lower risk of surgical complications than the alternatives of stenting and carotid endarterectomy,” explains Dr. Russell Wood of Washington Regional Cardiovascular and Thoracic Surgery Clinic, a part of the Walker Heart Institute.

The TCAR procedure is performed under general anesthesia and the artery in the neck is accessed through a small incision at the base of the neck.

“We then directly canulate 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,” Dr. Wood says. “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.”

Dr. Wood says most patients have no pain following the procedure. “They don't require any type of pain medicine 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.”