It was reported that a (b)(6) year old male patient underwent a right transcarotid artery revascularization (tcar) procedure on (b)(6) 2020.When the physician attempted to insert the enroute.035 wire, it was not stabilized upon enroute sheath insertion.The physician pulled back from the external carotid into the proximal common carotid artery (cca) which appeared to cause a dissection in the patient's cca.The physician then attempted to rotate the sheath advance the wire, but this was unsuccessful.A decision was then made to close the arteriotomy with a pre-close stitch and re-access.The physician then placed new pre-close stitch slightly distal to prior access.The enhance.018 access wire would not advance either, therefore the physician decided to close that access as well and convert to cea (carotid endarterectomy).The physician successfully performed the cea on the right internal carotid artery (rica).Using imaging to reassess post flow dynamics the physician noticed the dissection flap in the mid common carotid artery.The physician then gained retrograde access in the rica and proceeded with stenting (enroute stent 8x30) the mid rica in a retrograde fashion.The physician was satisfied with the final imaging and completed the case.The patient was extubated and was able to follow commands, moving all 4 extremities without difficulty.No additional details were provided.
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