A systematic review and meta-analysis has found that transcarotid artery revascularisation (TCAR) is associated with “promising early and late outcomes” in patients with internal carotid artery stenosis, although symptomatic patients still carry a higher risk of early cerebrovascular events. This is the conclusion of George C Galyfos (Hippocration Hospital, Athens, Greece) and colleagues, whose work was published as an Editor’s Choice paper in the European Journal of Vascular and Endovascular Surgery (EJVES).
The authors state that either carotid endarterectomy (CEA) and transfemoral carotid stenting (tfCAS) are usually recommended for the treatment of significant carotid stenosis. However, they note that both techniques have certain limitations. “Open surgery is associated with higher surgical stress, and could be the cause of the higher cardiac risk compared with stenting,” they elaborate, while tfCAS, on the other hand, carries the risk of intraoperative embolisation and chronic renal insufficiency, among others.
“[TCAR] offers an alternative strategy in patients where CEA or transfemoral stenting face difficulties,” Galyfos et al write. This review aimed to evaluate pooled data on patients undergoing TCAR and—in contrast to other similar reviews— evaluates both early and late outcomes as well as the effect of preoperative symptoms on early stroke/transient ischaemic attach (TIA), the authors detail.
Read More: https://vascularnews.com/tcar-associated-with-promising-early-and-late-outcomes-pooled-data-suggest/