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The TCAR Procedure: Transcarotid Artery Revascularization

Dr. DeCaprio is now providing patients with carotid disease an alternative to conventional surgery: TCAR

A potential complication of both surgery (carotid endarterectomy, or CEA) and stenting for stroke prevention in patients with carotid artery disease is a stroke occurring during the procedure itself. Studies have shown a higher risk of stroke during conventional stenting as compared to surgery.

The new minimally invasive transcarotid artery revascularization (TCAR) procedure that uses a special transcarotid neuro-protection system (NPS) is designed to reduce the risk of stroke during the insertion of the stent.

The novel NPS device allows the surgeon to directly access the common carotid artery in the neck and initiate high-rate temporary blood flow reversal to protect the brain from stroke while delivering and implanting the stent.

The TCAR procedure is performed through a small incision at the neckline just above the clavicle. This incision is much smaller than a typical CEA incision. The surgeon places a tube directly into the carotid artery and connects it to the NPS that directs blood flow away from the brain, to protect against plaque that may come loose reaching the brain.

The TCAR procedure offers patients a safer method of carotid stenting through a small incision at the base of the neck and direct carotid artery access along with neuro-protective flow reversal during delivery of the stent.

The patient’s blood flows through the NPS and any material is captured in a filter outside the body. The filtered blood is then returned through a second tube in the patient’s upper leg. After the stent is placed successfully, flow reversal is turned off and blood flow resumes in its normal direction.

TCAR not only obviates the need to navigate catheters through the aortic arch (a step linked to stroke during carotid stenting through the groin), but also prevents fragments of plaque released during stenting from travelling with the bloodstream to the brain and causing small or bigger strokes.

Commenting on TCAR, Jeffrey DDeCaprio MD a board certified vascular surgeon with 20 years of experience states:

In Texarkana I treat all aspects of vascular disease . The majority of my procedures for limb salvage and aortic aneurysms are performed with minimally invasive surgery that result in quicker recoveries and much less perioperative morbidity and mortality.

The TCAR procedure now provides a safe alternative to conventional surgery. Unlike carotid stenting done from a groin approach the TCAR procedure using the special neuroprotective device is much safer. Patients recover faster .

Over the last several months we have successfully performed TCAR on over 20 high risk patients with excellent results.

For more information on the procedure please visit