Association of Transcarotid Artery Revascularization vs Transfemoral Carotid Artery Stenting With Stroke or Death Among Patients With Carotid Artery Stenosis

Outcomes of Carotid Revascularization in Patients with Contralateral Carotid Artery Occlusion

“…12 Previous studies have shown a reduction in adverse outcomes after TCAR compared to TFCAS, due to circumventing the aortic arch through direct access of the common carotid artery in addition to the robust neuroprotective mechanism of the flow reversal used during TCAR. 31,32 Our study confirms these favorable outcomes, even in patients with CCO, where TCAR was superior to TFCAS independent of symptomatic status.…”

Society for Vascular Surgery clinical practice guidelines for management of extracranial cerebrovascular disease

“…44,45 A more recent study examined 3286 propensity-matched patients from the VQI and demonstrated a significantly lower incidence of in-hospital stroke and death for the patients treated with TCAR vs TF-CAS (1.6% vs 3.1%; RR, 0.51; 95% CI, 0.37-.72). 47 No difference was found in MI between the groups. Finally, Malas et al 48 examined a more recent cohort of patients from the VQI Transcarotid Revascularization Project.…”

The conundrum of asymptomatic carotid stenosis—determinants of decision and evidence

“…Long-term outcomes and durability of both techniques are similar, according to data providing from CREST (118), ACT-1 (113) and ICSS (111) (symptomatic patients) trials. CAS techniques performed by very experienced operators with large caseloads (119,120), the use of reversed-flow protection and transcarotid revascularization (TCAR) (121)(122)(123) might be safer but require further evaluations.…”