Propensity score-matched analysis of 1-year outcomes of transcarotid revascularization with dynamic flow reversal, carotid endarterectomy, and transfemoral carotid artery stenting

Use of Transcarotid Artery Revascularization, Transfemoral Carotid Artery Stenting, and Carotid Endarterectomy in the US From 2015 to 2019

“… 30 In retrospective analyses, TCAR has demonstrated comparable rates of stroke and death but half the risk of in-hospital transient ischemic attack, stroke, and mortality compared with TFCAS. 14 , 31 , 32 A meta-analysis of 30-day mortality rates with TCAR and TFCAS reported that TCAR had lower perioperative stroke and death rates compared with CEA. 33 However, there are currently no randomized clinical trials comparing outcomes for TCAR vs TFCAS or CEA, and long-term (>1 year) data are lacking.…”

“…These data are aligned with increasing reports that TCAR performs relatively similarly to CEA. 18 , 32 , 40 , 41 , 42 Given that TCAR use increased and CEA use decreased in the 2015 through 2019 period, it is encouraging to see a lack of change in major complications. We attempted to analyze center-level major complications by stratifying according to TCAR use, but we found no difference in outcomes overall or on an annual basis for high-volume or low-volume TCAR centers.…”

Comparison of Recent Practice Guidelines for the Management of Patients With Asymptomatic Carotid Stenosis

“…Transcarotid artery revascularization (TCAR) is a novel approach which is quickly gaining support. [25][26][27] Current evidence suggests that TCAR is associated with similar stroke/death rates with CEA and with better outcomes compared with transfemoral CAS. [25][26][27] However, TCAR is not yet widely available.…”

“…[25][26][27] Current evidence suggests that TCAR is associated with similar stroke/death rates with CEA and with better outcomes compared with transfemoral CAS. [25][26][27] However, TCAR is not yet widely available. Furthermore, so far there is no available data for TCAR from RCTs.…”

Optimal periprocedural antithrombotic treatment in carotid interventions: An international, multispecialty, expert review and position statement

“…A novel carotid intervention has been introduced in the last few years, TCAR, which is quickly gaining ground in the interventional management of AsxCS/SCS patients. [61][62][63] Recent studies have proposed the use of ticagrelor as one of the two antiplatelets agents instead of clopidogrel in DAPT (Table 3). [52][53][54] These early promising results with ticagrelor need to be verified in larger studies and RCTs.…”