SSM TCAR Exam 2025 Complete Verified
Questions And Correct Detailed Answers
latest (Verified Answers)| Graded A+
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1. What is the primary goal of the TCAR procedure?
To minimize perioperative stroke risk during carotid artery
revascularization
TCAR (TransCarotid Artery Revascularization) is designed to reduce stroke
risk by reversing blood flow during stenting.
2. Which device is used to reverse flow during TCAR?
Enroute Neuroprotection System
This system creates flow reversal to prevent emboli from reaching the brain
during stent placement.
3. Which artery is surgically accessed during TCAR?
Common carotid artery
Unlike transfemoral carotid stenting, TCAR directly accesses the common
carotid artery in the neck.
4. The patient is positioned in what position during TCAR?
Supine with neck extended and turned contralaterally
This position optimizes exposure of the carotid artery for surgical access.
,5. What is the most common complication of TCAR?
Cranial nerve injury
Although rare, injury to nerves like the hypoglossal or vagus can occur due
to the neck dissection required.
6. Which condition is a contraindication for TCAR?
Severe carotid tortuosity proximal to the lesion
Excessive vessel tortuosity can make stent delivery and flow reversal
ineffective or unsafe.
7. Which anticoagulant is typically used intraoperatively during TCAR?
Heparin
Systemic heparinization reduces the risk of thrombosis during the
procedure.
8. Which imaging modality is standard for intraoperative guidance?
Fluoroscopy
Real-time fluoroscopy is used to guide wire and stent placement.
9. What is the minimum target activated clotting time (ACT) during TCAR?
250–300 seconds
Adequate anticoagulation minimizes thrombus formation during the
procedure.
10.Which type of anesthesia is most commonly used for TCAR?
Local anesthesia with sedation
This allows monitoring of neurologic status while minimizing hemodynamic
instability.
, 11.A patient develops bradycardia during carotid sinus manipulation. What
should be given?
Atropine
Atropine counteracts vagal stimulation causing bradycardia.
12.The Enroute system achieves neuroprotection by what mechanism?
Flow reversal
By reversing flow, embolic debris is directed away from the brain.
13.Which vessel is used for venous return in the Enroute system?
Femoral vein
Blood is shunted from the carotid artery to the femoral vein, creating the
flow reversal.
14.What is the recommended minimum common carotid artery diameter for
TCAR?
≥6 mm
A small diameter may not accommodate the sheath safely.
15.The recommended post-procedure antiplatelet therapy includes:
Dual antiplatelet therapy (DAPT)
DAPT with aspirin and clopidogrel reduces risk of in-stent thrombosis.
16.Which monitoring is essential during flow reversal?
Neurologic status
Continuous neurologic checks help detect ischemic events early.
17.Which vessel disease location is ideal for TCAR?
High cervical carotid lesions
Questions And Correct Detailed Answers
latest (Verified Answers)| Graded A+
Guaranteed Pass
1. What is the primary goal of the TCAR procedure?
To minimize perioperative stroke risk during carotid artery
revascularization
TCAR (TransCarotid Artery Revascularization) is designed to reduce stroke
risk by reversing blood flow during stenting.
2. Which device is used to reverse flow during TCAR?
Enroute Neuroprotection System
This system creates flow reversal to prevent emboli from reaching the brain
during stent placement.
3. Which artery is surgically accessed during TCAR?
Common carotid artery
Unlike transfemoral carotid stenting, TCAR directly accesses the common
carotid artery in the neck.
4. The patient is positioned in what position during TCAR?
Supine with neck extended and turned contralaterally
This position optimizes exposure of the carotid artery for surgical access.
,5. What is the most common complication of TCAR?
Cranial nerve injury
Although rare, injury to nerves like the hypoglossal or vagus can occur due
to the neck dissection required.
6. Which condition is a contraindication for TCAR?
Severe carotid tortuosity proximal to the lesion
Excessive vessel tortuosity can make stent delivery and flow reversal
ineffective or unsafe.
7. Which anticoagulant is typically used intraoperatively during TCAR?
Heparin
Systemic heparinization reduces the risk of thrombosis during the
procedure.
8. Which imaging modality is standard for intraoperative guidance?
Fluoroscopy
Real-time fluoroscopy is used to guide wire and stent placement.
9. What is the minimum target activated clotting time (ACT) during TCAR?
250–300 seconds
Adequate anticoagulation minimizes thrombus formation during the
procedure.
10.Which type of anesthesia is most commonly used for TCAR?
Local anesthesia with sedation
This allows monitoring of neurologic status while minimizing hemodynamic
instability.
, 11.A patient develops bradycardia during carotid sinus manipulation. What
should be given?
Atropine
Atropine counteracts vagal stimulation causing bradycardia.
12.The Enroute system achieves neuroprotection by what mechanism?
Flow reversal
By reversing flow, embolic debris is directed away from the brain.
13.Which vessel is used for venous return in the Enroute system?
Femoral vein
Blood is shunted from the carotid artery to the femoral vein, creating the
flow reversal.
14.What is the recommended minimum common carotid artery diameter for
TCAR?
≥6 mm
A small diameter may not accommodate the sheath safely.
15.The recommended post-procedure antiplatelet therapy includes:
Dual antiplatelet therapy (DAPT)
DAPT with aspirin and clopidogrel reduces risk of in-stent thrombosis.
16.Which monitoring is essential during flow reversal?
Neurologic status
Continuous neurologic checks help detect ischemic events early.
17.Which vessel disease location is ideal for TCAR?
High cervical carotid lesions
