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Transcarotid Artery Revascularization (TCAR): What to Expect at Home

Carotid artery on side of neck, with detail of inside the artery showing plaque limiting blood flow and detail of inserted stent improving blood flow.

Your Recovery

Transcarotid artery revascularization (TCAR) is a procedure to open a narrowed carotid artery. This is done by placing a tiny expandable tube (stent) into the artery. The doctor made a small cut (incision) in your neck to place the stent. A very small incision may have been made in your groin area.

You may have soreness, a bruise, and mild swelling where the doctor made the incision in your neck. You may also have swelling, bruising, or a small lump around the site where the catheter went into your groin. You can do light activities around the house. But don't do anything strenuous until your doctor says it is okay. This lets the incision sites heal.

You will take medicines to help prevent a stroke. You will still need to have a heart-healthy lifestyle. This lifestyle includes eating healthy foods, being active, staying at a healthy weight, and not smoking. This will give you the best chance for a longer, healthier life.

You will have regular tests to check the blood flow in your carotid arteries.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

If the doctor gave you a sedative:
- For 24 hours, don't do anything that requires attention to detail, such as going to work, making important decisions, or signing any legal documents. It takes time for the medicine's effects to completely wear off.
- For your safety, do not drive or operate any machinery that could be dangerous. Wait until the medicine wears off and you can think clearly and react easily.
Do not do strenuous exercise and do not lift, pull, or push anything heavy until your doctor says it's okay. This may be for several days. Try not to walk up stairs for the first couple of days. You can walk around the house and do light activity, such as cooking.
If your doctor recommends it, be active. Walking is a good choice. Bit by bit, increase the amount you walk every day. Try for at least 2½ hours a week.
Ask your doctor when you can drive again.
Your doctor will tell you when you can have sex again.
Carry your stent identification card with you at all times.

Diet

You may notice that your bowel movements are not regular right after your procedure. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.
Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
Keep eating a heart-healthy diet that has lots of fruits, vegetables, and whole grains. If you need help with your diet, talk to your doctor. You also may want to talk to a dietitian. This expert can help you learn about healthy foods and plan meals.

Medicines

Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine.
Your doctor may prescribe a blood thinner such as aspirin. It is important that you take these medicines exactly as directed to help reduce your risk of a stroke. Be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.

Care of the groin catheter site

For 1 day or for as long as your doctor recommends, keep a bandage over the spot where the doctor put the catheter in your groin.
Put ice or a cold pack on the area for 10 to 20 minutes at a time to help with soreness or swelling. Put a thin cloth between the ice and your skin.
You may shower 24 to 48 hours after the procedure, if your doctor okays it. Pat the incision dry.
Do not soak the catheter site until it is healed. Don't take a bath for 1 week, or until your doctor tells you it is okay.
Watch for bleeding from the site. A small amount of blood (up to the size of a quarter) on the bandage can be normal.
If you are bleeding, lie down and press on the area for 15 minutes to try to make it stop. If the bleeding does not stop, call your doctor or nurse advice line or seek immediate medical care.

Incision care

If you have strips of tape over your incision, leave the tape on for a week or until it falls off.
You may shower and take baths as usual. But do not soak the incision for the first 2 weeks, or until your doctor tells you it is okay. Pat the incision dry.
Wash the area daily with water and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing. You may cover the area with a gauze bandage if it oozes fluid or rubs against clothing. Change the bandage every day.
Keep the area clean and dry.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have severe trouble breathing.
You have a tight bulge in your neck on the side where the incision was made.
You have symptoms of a stroke. These may include:
- Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
- Sudden vision changes.
- Sudden trouble speaking.
- Sudden confusion or trouble understanding simple statements.
- Sudden problems with walking or balance.
- A sudden, severe headache that is different from past headaches.
You have symptoms of a heart attack. These may include:
- Chest pain or pressure or a strange feeling in the chest.
- Sweating.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
- Light-headedness or sudden weakness.
- A fast or irregular heartbeat.
After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.

Call your doctor or nurse advice line now or seek immediate medical care if:

You are bleeding from the area where the catheter was put in your groin.
You have a fast-growing, painful lump at the catheter site.
Your leg is painful, looks blue, or feels cold, numb, or tingly.
You have pain that does not get better after you take pain medicine.
You have loose stitches, or your incision comes open.
Bright red blood has soaked through the bandage over your incision.
You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness of the skin.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.