Transcarotid Artery Revascularization Results in Low Rates of Periprocedural Neurologic Events, Myocardial Infarction, and Death

Lackey, Angelica R.; Erben, Young; Franco, Joao Antonio Da Rocha; Meschia, James F.; Lal, Brajesh K.

doi:10.1007/s11886-020-1256-z

Cited by 12 publications

(12 citation statements)

References 45 publications

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“…17 Second, it avoids all aforementioned barriers associated with a transfemoral endovascular approach. 7 In a systematic review by Sfyroeras et al, thirty-day mortality and stroke rate after hybrid treatment of combined carotid lesions were 0.7% and 1.5%, respectively. 15 They describe 2 types of surgical technique.…”

Section: Discussionmentioning

confidence: 98%

“…6 However, extended femoral or iliac atherosclerosis and calcifications of the aortic arch are main limitations for any transfemoral procedure. 7 Therefore, the transcervical approach has been introduced as a novel technique to overcome such limitations. 8 The co-existence of an internal carotid artery (ICA) stenosis, however, definitely complicates such a procedure, and surgical strategy should be modified.…”

Section: Introductionmentioning

confidence: 99%

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Hybrid Repair of a Common Carotid Pseudoaneurysm and Concomitant Internal Carotid Stenosis With Retrograde Stenting and Carotid Endarterectomy

Zarmakoupis

Galyfos

Tsoukalos

et al. 2021

Vasc Endovascular Surg

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This report aims to present a rare case of a common carotid artery (CCA) pseudoaneurysm with a concomitant internal carotid artery (ICA) stenosis that were treated with a hybrid technique. This strategy included the retrograde placement of a CCA covered stent under ICA clamping followed by standardized carotid endarterectomy. The technique will be discussed and compared with other possible treatments.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Hybrid Repair of a Common Carotid Pseudoaneurysm and Concomitant Internal Carotid Stenosis With Retrograde Stenting and Carotid Endarterectomy

Zarmakoupis

Galyfos

Tsoukalos

et al. 2021

Vasc Endovascular Surg

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“…Among patients at high risk, the increased use of TCAR was even greater; by 2019, TCAR represented 53.2% of all carotid revascularization procedures for patients at high risk, increasing from 2.8% in 2015. In addition, TCAR offers the unique benefit of neuroprotection through flow reversal without the need for aortic arch manipulation, 26 , 27 , 28 , 29 which is often believed to be the main source of atheroembolic events during TFCAS. 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.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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IMPORTANCE A transcarotid artery revascularization (TCAR) device was approved by the US Food and Drug Administration in 2015 for carotid revascularization in patients at high risk for stroke, cranial nerve injury, or major cardiac event. It is unclear how the introduction of TCAR has changed the use of carotid endarterectomy (CEA) and transfemoral carotid artery stenting (TFCAS).OBJECTIVE To quantify the temporal changes in the operative approach to carotid revascularization (CEA vs TFCAS vs TCAR), and to identify patient and disease characteristics commonly associated with each approach.

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“…As the two effective therapies used for CS frequently, TF-CAS and CEA are unavoidable topics, however, the latter has most likely to be recommended due to the lower risk of stroke (43). Nowadays, a novel technique composed of carotid stenting and specially designed device was seen as a third strategy for treating CS, which received positive comment and efficacy, and distinctly reduced adverse events within the perioperative period (44)(45)(46). Therefore, it is necessary to study the prognosis of patients who underwent TCAR compared to CEA in a larger sample size and to explore whether there are differences related to symptom status.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Transcarotid Artery Revascularization With Flow Reversal System Compared to Carotid Endarterectomy: A Systematic Review and Meta-Analysis

Gao

Chen

Kou

et al. 2021

Front. Cardiovasc. Med.

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Background: Carotid artery stenosis has long been a critical cause of stroke and death, and it can seriously affect the life quality. Transcarotid artery revascularization (TCAR) and carotid endarterectomy (CEA) are both feasible therapies for this disease. This systematic review and meta-analysis aim to evaluate if the efficacy of the two approaches is comparable.Methods: Clinical studies up to March 2021 were searched through PubMed, Embase, and Scopus from a computer. The screening process was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Newcastle-Ottawa Scale (NOS) was used for methodological quality assessment of works of literature meeting the inclusion criteria, and Review Manager 5.4 was used for data synthesis. The I2 statistic was performed to measure the heterogeneity, and M-H/I-V fixed or random model was utilized depending on the I2 value. The evidence evaluation was accomplished based on grades of recommendation, assessment, development, and evaluation (GRADE) online tool.Results: A total of 14,200 subjects (six comparative studies) were finally included in this pooled study. There is no statistical discrepancy between the two treatments on reducing stroke/death/myocardial infarction (odds ratio [OR] 0.85, 95% CI 0.67–1.07), stroke (OR 1.03, 95% CI 0.77–1.37), or death (OR 1.14, 95% CI 0.67–1.94). Besides, TCAR is associated with a lower incidence of myocardial infarction (P = 0.004), cranial nerve injury (P < 0.00001), and shorter procedure time (P < 0.00001) than CEA among the overall cohort.Conclusions: TCAR is a rapidly developing treatment that reaches a comparable prognosis to CEA and significantly reduces the risk of myocardial infarction under the well-matched condition, which is a dependable choice for patients with carotid stenosis.

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Transcarotid Artery Revascularization Results in Low Rates of Periprocedural Neurologic Events, Myocardial Infarction, and Death

Cited by 12 publications

References 45 publications

Hybrid Repair of a Common Carotid Pseudoaneurysm and Concomitant Internal Carotid Stenosis With Retrograde Stenting and Carotid Endarterectomy

Hybrid Repair of a Common Carotid Pseudoaneurysm and Concomitant Internal Carotid Stenosis With Retrograde Stenting and Carotid Endarterectomy

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

The Efficacy of Transcarotid Artery Revascularization With Flow Reversal System Compared to Carotid Endarterectomy: A Systematic Review and Meta-Analysis

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