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New Vascular Procedures available to Veterans in Lebanon

Photo of part of the vascular surgery team involved in the first TCAR procedure
From left to right in the photo: Jill Cullen, RN; Daniel Pluta, RN; Paul Hoy, ST; Sonya Tuerff, MD and Ivan Huertas, RN stand in the vascular surgery suite at Lebanon VA Medical Center (VAMC).

Veterans in need of carotid artery stenosis can now be treated at Lebanon VAMC. On February 28, 2023, Lebanon’s vascular surgery team completed their first two Transcarotid Artery Revascularization (TCAR) procedures.

TCAR offers a minimally invasive approach that clears blockages and decreases the risk of stroke. A balloon and stent are used to reopen the carotid artery and remove any debris from inside the artery.

Prior to vascular surgeon, Sonya Tuerff, MD, starting at Lebanon VA Medical Center last fall, all vascular procedures were referred to community care. Dr. Tuerff’s expertise expands vascular offerings to angioplasty, stent placement, abdominal aortic aneurysm stent grafts, among other endovascular procedures. Now, TCAR has been added to that growing list. 

The goal in vascular procedures is to increase blood flow. Historically vascular procedures, like carotid endarterectomy, required open surgery that increased the risk of complications and required longer hospital stays. Recovery following the TCAR procedure is relatively quick; patients can expect a one or two-night stay in the hospital. 

Dr. Tuerff said "I'm pleased with the teamwork and support from all my colleagues here to be able to provide the TCAR option to Veterans when it’s appropriate. It's a testament to the I-CARE values instilled in VA staff who work so hard to give Veterans the best outcomes possible." 

Anesthesiology plays a crucial role in the TCAR procedure. Srikantha Rao, MD, lead anesthesiologist, 
said “During TCAR, brain function monitoring is performed paying attention to regional cerebral oxygenation and surface electroencephalography monitoring. We are grateful to our administration for investing in the necessary equipment required for precise physiologic monitoring under anesthesia so that we may offer innovative techniques like TCAR to Veterans.”

The TCAR procedure is a preferable option for Veterans who have a higher risk of complications from traditional carotid surgery due to their age or other medical conditions. If you feel that you might benefit from vascular surgery, talk to your primary care physician to discuss your options.

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