"TCAR or nothing": the only options for some complex carotid stenosis.

Area of Science:

• Vascular Surgery
• Interventional Neurology
• Medical Device Technology

Background:

• Carotid artery disease poses a significant stroke risk.
• Traditional treatments include carotid endarterectomy and transfemoral stenting.
• Transcervical carotid artery revascularization is an emerging alternative.

Purpose of the Study:

• To present four challenging cases of carotid artery lesions.
• To demonstrate the feasibility of transcervical carotid artery revascularization when other options are limited.
• To highlight the successful use of the Enroute stent in complex anatomies.

Main Methods:

• Retrospective review of four patients undergoing transcervical carotid artery revascularization.
• Utilized intraoperative planning to address specific technical challenges.
• Deployed the Enroute stent (Silk Road Medical) for lesion treatment.

Main Results:

• Successful treatment of complex carotid artery stenosis in all four cases.
• Demonstrated safe deployment of the Enroute stent.
• Achieved resolution of stenosis in each patient.

Conclusions:

• Transcervical carotid artery revascularization is a valuable option for complex carotid lesions.
• Careful intraoperative planning is crucial for successful outcomes.
• The Enroute stent facilitates treatment in challenging anatomical scenarios.