Transcarotid revascularization outcomes do not differ by patient age or sex
Minerva Mayorga-Carlin1, Palma Shaw2, Kathleen Ozsvath3
1Division of Vascular Surgery, University of Maryland, Baltimore, MD.
Journal of Vascular Surgery
|March 31, 2022
Summary
Transcarotid artery revascularization (TCAR) is safe and effective for both men and women, as well as older and younger adults. Procedural outcomes and complication rates for TCAR do not differ significantly across these demographic groups.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Neurosurgery
Background:
- Transcarotid artery revascularization (TCAR) is an emerging hybrid technique for treating carotid artery disease.
- Existing data on TCAR's comparative safety and performance across different demographic groups, specifically sex and age, remain limited.
Purpose of the Study:
- To investigate potential differences in periprocedural complications and performance metrics of TCAR between men and women.
- To evaluate variations in TCAR outcomes based on patient age (younger vs. older adults).
Main Methods:
- Analysis of a global TCAR quality assurance database (March 2009 - May 2020) including patient, lesion, and physician characteristics.
- Recording of clinical composite (death, stroke, TIA, MI) and technical composite (aborted procedure, conversion, bleeding, etc.) adverse events within 24 hours.
- Comparison of four performance measures: flow-reversal time, fluoroscopy time, contrast volume, and skin-to-skin time, using Poisson and linear regressions.
Main Results:
- A total of 18,240 TCAR procedures were analyzed; 34.9% of patients were women.
- No significant differences were observed in adjusted clinical or technical composite adverse event rates between women and men (P=.22 and P=.93, respectively).
- Age did not significantly affect clinical or technical adverse event rates (P=.65 and P=.55, respectively). Minor, clinically insignificant differences were noted in procedural times by age and sex.
Conclusions:
- TCAR demonstrates comparable clinical and technical safety and efficacy regardless of patient age or sex.
- The findings support TCAR as a suitable and preferred carotid revascularization method for diverse patient populations, including women and older adults.
