TransCarotid Artery Revascularization (TCAR)

SilkRoad Medical: TCAR Procedure

Technical aspects of transcarotid artery revascularizationusing the ENROUTE transcarotid neuroprotection and stent system. J Vasc Surg 2017;65:916-20.

TCAR PPT Stony Brook

TCAR With Flow Reversal Is Equal To CEA For Treating High Risk Patients With Carotid Stenosis:DWMRI Findings Prove It (From The PROOF Trial)

Long-term comparative effectiveness of carotid stenting versus carotid endarterectomy in a large tertiary care vascular surgery practice. Journal of Vascular Surgery. Volume 68, Issue 4, October 2018, Pages 1039-1046.

THE CASE FOR TCAR UNDER LOCAL ANESTHESIA PPT: Dec 2017.

Challenging Case: The Consequence of Unmanaged Hypotension After TCAR. Endovascular Today. August 2019.

Preop

• Dual antiplatelet therapy: Aspirin and clopidogrel
• Statins
• Beta blocker

Intraop

• Local/MAC vs General
• arterial line
• Target systolic blood pressure is 140 – 160 mmHg. Consider glycopyrrolate adn vasopressors for hemodynamics.
• Surgical access: common carotid artery and femoral vein
• Goal ACT: 250-300

Postop

• Neuro checks – quick emergence from anesthesia prior to leaving OR
• ICU postop
• Tight BP control

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