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Technical tips for success in transcarotid artery revascularization
Andrew C Schroeder1, Mark D Balceniuk1, Armand Sebastian1
1Division of Vascular Surgery, Department of Surgery, University of Rochester, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642.
Seminars in Vascular Surgery
|November 21, 2020
Summary
Transcarotid artery revascularization (TCAR) offers a minimally invasive approach for carotid artery stenosis management. This technique provides effective cerebral protection, achieving low perioperative neurologic morbidity in patients.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Neurology
Background:
- Carotid artery stenosis poses a significant risk for stroke.
- Traditional transfemoral approaches for stenting carry risks of cerebral embolization.
- Minimally invasive techniques are sought to improve patient outcomes.
Purpose of the Study:
- To detail the technique of transcarotid artery revascularization (TCAR).
- To evaluate the safety and efficacy of TCAR with the ENROUTE Transcarotid Neuroprotection System.
- To report perioperative neurologic morbidity and long-term clinical and hemodynamic success.
Main Methods:
- Direct common carotid artery access for stent placement.
- Utilizing the ENROUTE Transcarotid Neuroprotection System for cerebral protection.
- Predilation of lesions prior to stent deployment.
- Procedure performed on 70 patients (112 procedures).
Main Results:
- Low perioperative neurologic morbidity (<1%).
- Successful clinical and hemodynamic outcomes documented via duplex ultrasound.
- Sustained success observed at over 6 months' follow-up.
Conclusions:
- Transcarotid artery revascularization (TCAR) is a safe and effective minimally invasive option for carotid artery stenosis.
- The ENROUTE system provides robust cerebral protection during TCAR.
- TCAR demonstrates excellent long-term clinical and hemodynamic results.
