Transcarotid artery revascularization (TCAR): a technical video

Area of Science:

• Vascular Surgery
• Interventional Neurology
• Medical Device Technology

Background:

• Stroke prevention is critical, with carotid revascularization being a key strategy.
• Traditional methods include carotid endarterectomy and transfemoral carotid angioplasty and stenting.
• Transcarotid artery revascularization (TCAR) is an emerging hybrid open-endovascular approach.

Purpose of the Study:

• To provide a technical overview of the Transcarotid artery revascularization (TCAR) procedure.
• To highlight operative techniques and procedural nuances for neurovascular specialists.
• To facilitate the adoption of TCAR into routine clinical practice.

Main Methods:

• Detailed review of Transcarotid artery revascularization (TCAR) operative techniques.
• Emphasis on the proximal neuroprotection strategy utilizing flow reversal.
• Focus on practical aspects for proceduralists adopting the TCAR technique.

Main Results:

• TCAR combines open surgical principles with endovascular stenting.
• The procedure incorporates a distinct neuroprotection mechanism via flow reversal.
• This video serves as a guide for implementing TCAR.

Conclusions:

• Transcarotid artery revascularization (TCAR) represents an advancement in carotid stenting.
• The flow reversal neuroprotection is a key differentiator from transfemoral approaches.
• TCAR offers a valuable option for stroke prevention strategies.