Transcarotid artery revascularization can safely be performed with regional anesthesia and no intensive care unit stay

An international, multispecialty, expert-based Delphi Consensus document on controversial issues in the management of patients with asymptomatic and symptomatic carotid stenosis

“…TCAR has emerged as a considerably better revascularization option compared with transfemoral CAS and is quickly gaining ground in the management of patients with AsxCS and SxCS. Advantages of this procedure include that it can be performed safely under local anesthesia and no intensive care unit stay, 92 with stroke/ death rates comparable to those of the gold-standard CEA. 93 Disadvantages include the limited availability of the procedure outside the U.S. and its relatively high cost, 94 but hopefully these will improve in the future.…”

What Is the Role of Transcarotid Artery Revascularization?

“…Following an uneventful TCAR, patients should be monitored for 24 hours, as an embolic stroke, hypotension with or without bradycardia or hypertension can occur during this early postoperative period [71,78]. It should be ascertained that the postoperative neurologic assessment continues to be normal or at baseline.…”