TCAR Post-Test – Real Exam Questions with
Page | 1
Correct Answers (A+ Graded, Verified Content)
1. Which of the following best describes the primary goal of TCAR (Transcarotid
Artery Revascularization)?
A. Prevent hemorrhagic stroke
B. Decrease cholesterol levels
C. Reduce the risk of embolic stroke by treating carotid artery stenosis
D. Manage atrial fibrillation
✅ Correct Answer: C
Rationale: TCAR is specifically designed to treat significant carotid artery stenosis while
reducing the risk of stroke by minimizing embolic events during the procedure.
2. What is the main reason TCAR is considered safer than traditional carotid
endarterectomy in certain patients?
A. It is performed under general anesthesia
B. It reverses blood flow to prevent emboli from reaching the brain
C. It uses open-heart bypass
D. It doesn't require imaging guidance
✅ Correct Answer: B
Rationale: TCAR uses temporary flow reversal to protect the brain during the procedure,
reducing stroke risk.
3. During TCAR, where is the stent typically placed?
A. Aortic arch
B. Vertebral artery
C. Common to internal carotid artery segment
D. Subclavian artery
✅ Correct Answer: C
, Rationale: The stent is deployed in the diseased segment of the carotid artery—specifically the
internal carotid—via a direct access of the common carotid artery.
Page | 2 4. Which patient is most likely to benefit from TCAR over carotid
endarterectomy?
A. Elderly patient with significant neck radiation history
B. Young healthy patient with no surgical contraindications
C. Patient with stable angina
D. Pregnant woman in the third trimester
✅ Correct Answer: A
Rationale: TCAR is particularly advantageous in high-surgical-risk patients, such as the elderly
or those with prior neck surgery or radiation.
5. Which of the following is a contraindication for TCAR?
A. Age over 75
B. Symptomatic carotid stenosis
C. Severe peripheral vascular disease precluding sheath insertion
D. Prior carotid stent
✅ Correct Answer: C
Rationale: If the peripheral vasculature cannot support sheath or device insertion, TCAR
becomes unfeasible.
6. Which monitoring device is essential during a TCAR procedure to assess
cerebral perfusion?
A. EKG
B. EEG or cerebral oximetry
C. Spirometer
D. TEE
✅ Correct Answer: B
Rationale: Monitoring brain perfusion with EEG or cerebral oximetry helps detect potential
ischemic changes during flow reversal.
7. What is the purpose of using flow reversal during TCAR?
, A. Speed up blood flow
B. Prevent plaque or emboli from traveling to the brain
C. Remove the need for antiplatelet therapy
D. Bypass the carotid artery
✅ Correct Answer: B
Page | 3 Rationale: Flow reversal acts as a neuroprotective measure by directing emboli away from the
cerebral circulation.
8. Which artery is most commonly accessed in TCAR?
A. Subclavian
B. Common carotid artery (via small neck incision)
C. Femoral
D. Radial
✅ Correct Answer: B
Rationale: A direct surgical approach to the common carotid is standard for TCAR.
9. What medication is essential before and after TCAR to reduce thrombotic
risk?
A. Warfarin only
B. Dual antiplatelet therapy (aspirin + clopidogrel)
C. Heparin only
D. Beta-blockers
✅ Correct Answer: B
Rationale: Dual antiplatelet therapy is standard to prevent clot formation on the stent.
10. Which potential complication should be monitored for after a TCAR
procedure?
A. Renal failure
B. Hemothorax
C. Stroke or transient ischemic attack
D. Deep vein thrombosis
✅ Correct Answer: C
Rationale: Despite precautions, stroke remains a potential complication due to manipulation of
the carotid artery.
, 11. What imaging modality is typically used before TCAR to assess carotid
stenosis severity?
A. Chest X-ray
B. Duplex ultrasound and/or CTA
Page | 4 C. PET scan
D. MRI of the brain only
✅ Correct Answer: B
Rationale: Duplex ultrasound and computed tomography angiography (CTA) are standard
imaging tools for evaluating carotid artery stenosis and planning TCAR.
12. A key advantage of TCAR over transfemoral carotid stenting is:
A. Lower stroke risk due to direct carotid access and flow reversal
B. Less use of anesthesia
C. Higher rates of restenosis
D. More vascular access complications
✅ Correct Answer: A
Rationale: TCAR significantly reduces the stroke risk by combining direct carotid access and
embolic protection.
13. Which of the following patients is NOT an ideal candidate for TCAR?
A. Patient with high bifurcation of the carotid artery
B. Patient with inaccessible or heavily calcified common carotid artery
C. Patient with recent TIA
D. Patient over age 80
✅ Correct Answer: B
Rationale: If the access site is not surgically approachable due to anatomy or calcification,
TCAR is not safe.
14. What is the most common access complication with TCAR?
A. Renal artery occlusion
B. Neck hematoma or bleeding
C. Pneumothorax
D. Femoral pseudoaneurysm
✅ Correct Answer: B
Page | 1
Correct Answers (A+ Graded, Verified Content)
1. Which of the following best describes the primary goal of TCAR (Transcarotid
Artery Revascularization)?
A. Prevent hemorrhagic stroke
B. Decrease cholesterol levels
C. Reduce the risk of embolic stroke by treating carotid artery stenosis
D. Manage atrial fibrillation
✅ Correct Answer: C
Rationale: TCAR is specifically designed to treat significant carotid artery stenosis while
reducing the risk of stroke by minimizing embolic events during the procedure.
2. What is the main reason TCAR is considered safer than traditional carotid
endarterectomy in certain patients?
A. It is performed under general anesthesia
B. It reverses blood flow to prevent emboli from reaching the brain
C. It uses open-heart bypass
D. It doesn't require imaging guidance
✅ Correct Answer: B
Rationale: TCAR uses temporary flow reversal to protect the brain during the procedure,
reducing stroke risk.
3. During TCAR, where is the stent typically placed?
A. Aortic arch
B. Vertebral artery
C. Common to internal carotid artery segment
D. Subclavian artery
✅ Correct Answer: C
, Rationale: The stent is deployed in the diseased segment of the carotid artery—specifically the
internal carotid—via a direct access of the common carotid artery.
Page | 2 4. Which patient is most likely to benefit from TCAR over carotid
endarterectomy?
A. Elderly patient with significant neck radiation history
B. Young healthy patient with no surgical contraindications
C. Patient with stable angina
D. Pregnant woman in the third trimester
✅ Correct Answer: A
Rationale: TCAR is particularly advantageous in high-surgical-risk patients, such as the elderly
or those with prior neck surgery or radiation.
5. Which of the following is a contraindication for TCAR?
A. Age over 75
B. Symptomatic carotid stenosis
C. Severe peripheral vascular disease precluding sheath insertion
D. Prior carotid stent
✅ Correct Answer: C
Rationale: If the peripheral vasculature cannot support sheath or device insertion, TCAR
becomes unfeasible.
6. Which monitoring device is essential during a TCAR procedure to assess
cerebral perfusion?
A. EKG
B. EEG or cerebral oximetry
C. Spirometer
D. TEE
✅ Correct Answer: B
Rationale: Monitoring brain perfusion with EEG or cerebral oximetry helps detect potential
ischemic changes during flow reversal.
7. What is the purpose of using flow reversal during TCAR?
, A. Speed up blood flow
B. Prevent plaque or emboli from traveling to the brain
C. Remove the need for antiplatelet therapy
D. Bypass the carotid artery
✅ Correct Answer: B
Page | 3 Rationale: Flow reversal acts as a neuroprotective measure by directing emboli away from the
cerebral circulation.
8. Which artery is most commonly accessed in TCAR?
A. Subclavian
B. Common carotid artery (via small neck incision)
C. Femoral
D. Radial
✅ Correct Answer: B
Rationale: A direct surgical approach to the common carotid is standard for TCAR.
9. What medication is essential before and after TCAR to reduce thrombotic
risk?
A. Warfarin only
B. Dual antiplatelet therapy (aspirin + clopidogrel)
C. Heparin only
D. Beta-blockers
✅ Correct Answer: B
Rationale: Dual antiplatelet therapy is standard to prevent clot formation on the stent.
10. Which potential complication should be monitored for after a TCAR
procedure?
A. Renal failure
B. Hemothorax
C. Stroke or transient ischemic attack
D. Deep vein thrombosis
✅ Correct Answer: C
Rationale: Despite precautions, stroke remains a potential complication due to manipulation of
the carotid artery.
, 11. What imaging modality is typically used before TCAR to assess carotid
stenosis severity?
A. Chest X-ray
B. Duplex ultrasound and/or CTA
Page | 4 C. PET scan
D. MRI of the brain only
✅ Correct Answer: B
Rationale: Duplex ultrasound and computed tomography angiography (CTA) are standard
imaging tools for evaluating carotid artery stenosis and planning TCAR.
12. A key advantage of TCAR over transfemoral carotid stenting is:
A. Lower stroke risk due to direct carotid access and flow reversal
B. Less use of anesthesia
C. Higher rates of restenosis
D. More vascular access complications
✅ Correct Answer: A
Rationale: TCAR significantly reduces the stroke risk by combining direct carotid access and
embolic protection.
13. Which of the following patients is NOT an ideal candidate for TCAR?
A. Patient with high bifurcation of the carotid artery
B. Patient with inaccessible or heavily calcified common carotid artery
C. Patient with recent TIA
D. Patient over age 80
✅ Correct Answer: B
Rationale: If the access site is not surgically approachable due to anatomy or calcification,
TCAR is not safe.
14. What is the most common access complication with TCAR?
A. Renal artery occlusion
B. Neck hematoma or bleeding
C. Pneumothorax
D. Femoral pseudoaneurysm
✅ Correct Answer: B
