What is TCAR?
TCAR is a minimally invasive procedure that is performed to treat a blockage or narrowing of a main blood vessel in your neck that goes to your brain by inserting a hollow, metal coil in the vessel to open or re-expand the vessel so your brain receives adequate blood supply. The procedure is performed under general anesthesia, meaning, you will be completely asleep. You will be asked to start medication to thin your blood prior to the procedure. You will need to continue the medication after the procedure until your provider advises you to stop, approximately 6 months.
How is carotid stenting performed?
A small incision is made on your neck, near your clavicle, to expose your carotid artery. Then, a catheter is inserted into a large blood vessel through a small puncture site in your thigh. A small puncture is made in the carotid artery and connected to the catheter in your thigh. This will allow the blood from your carotid artery to be filtered through the puncture site in your thigh which decreases the risk of plaque breaking off from the blockage, causing a stroke. Your provider will take numerous x-rays and measurements to insure the appropriate stent is chosen during the procedure. Once the procedure is completed, the small incision on your neck is closed using absorbable suture. The catheter in your thigh is removed, and that puncture site is closed using an absorbable closure device. You will have a small bandage on your neck and one on your thigh which can be removed 24 hours after the procedure.
Are there risks?
There are always risks associated with any type of procedure. The risks of carotid stenting include, but are not limited to, bleeding, infection, blood vessel injury, stroke, weakness, paralysis, visual disturbance, contrast dye reaction, need for additional surgery, seizure, coma and death.
What will happen after the procedure?
Following the procedure, you will be transferred to the intensive care unit. Depending on what area we access, thigh or wrist, you will either need to lay flat in bed, with your legs straight for 3 hours or have a device on your wrist for 2 hours. Typically, you will spend one night in the hospital under close monitoring. The nurses and doctors will take your vital signs, perform neurological exams, and check your pulse, puncture site and incision at various times throughout your stay. If there are no concerns, you will likely be discharged home the next morning.
What will happen once I’m home?
You will be tired from the anesthesia medications, so resting is important. We advise against driving and making any important decisions until 24 hours after the procedure. You can use Tylenol, 650mg every 6 hours, as needed for discomfort.
Remove the dressings 24 hours after the procedure and leave the area open to air. Continue to monitor the sites for the next 7 days. You may shower 24 hours after the procedure and gently wash the area with soap and water. Pat dry with a clean towel. Do not rub the area. Avoid strenuous activity, lifting over 10lbs, hot tubs and riding a bike for 7 days. You may resume a regular diet, home medications and light activity such as walking. You will be given specific instruction to follow regarding taking your blood pressure after the procedure when you are discharged from the hospital.
What should I look out for?
Monitor the areas for redness, swelling, drainage, pain, bleeding or weakness/numbness in your leg. Bruising is normal. If you notice oozing from the site, experience swelling that is tense or your leg becomes cold or weak, develop arm/leg weakness, speech or visual changes, facial drooping or confusion, please contact our office immediately, or call 911.