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Fewer complications with transcarotid revascularization vs endarterectomy

Annals of Surgery
Reuters Health - 14/10/2020 - Transcarotid revascularization (TCAR) with dynamic flow reversal is associated with fewer complications, but similar rates of stroke or death, than gold-standard carotid endarterectomy (CEA), according to findings from the TCAR Surveillance Project. Transfemoral carotid-artery stenting (TFCAS) carries a higher risk of iatrogenic emboli than does CEA. By circumventing aortic-arch manipulation, TCAR with flow reversal protects against shed of emboli throughout the procedure. An earlier study of more than 3,000 matched pairs of patients found a 50% reduction in in-hospital stroke or death after TCAR (1.6%) compared with TFCAS (3.1%). In the current study, Dr. Mahmoud B. Malas of the University of California, San Diego, and colleagues used data from 8,104 TCAR procedures and more than 53,000 CEA procedures to compare perioperative outcomes. After matching 6,384 pairs of patients who underwent TCAR or CEA, the rates of in-hospi...

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