Dual Institutional Experience with Transcarotid Artery Revascularization

Autor: Mitchell J George, Regina Husman, Hanaa Dakour-Aridi, Akiko Tanaka, Mackenzie Madison, Raghu Motaganahalli, Katherin Leckie, S Keisin Wang
Rok vydání: 2022
Předmět:
Zdroj: Vascular and Endovascular Surgery. 57:35-40
ISSN: 1938-9116
1538-5744
DOI: 10.1177/15385744221127846
Popis: Introduction Transcarotid artery revascularization (TCAR) is a hybrid open and endovascular technique to treat carotid stenosis. The purpose of this study is to present a large cohort of patients who underwent TCAR at 2 high-volume TCAR health systems. Methods This study was a retrospective chart review of all instances of TCAR within the Memorial Hermann Health System and Indiana University Health, from December 2015-January 2022, using the ENROUTE Neuroprotection Device (Silk Road Medical, Sunnyvale, CA). We report patient demographics, intraoperative metrics, 30-day results and long-term results. Results In all, 750 patients underwent TCAR in the designated time period. Average patient age was 73 years, with 68% being male. Overall, 53.9% of patients had coronary artery disease, 45.4% had diabetes, and 36.9% were symptomatic. Technical success was achieved in 98.8% of patients with conversion to open endarterectomy in 1.1%. Average reverse flow time was 9.1 minutes with length of stay greater than 1 day 38%. Ipsilateral stroke rate within 30 days was 2.3% and long-term cumulative stroke rate was 3.0%. Death within 30 days occurred in 1.2% of patients and in 5.9% over long-term follow up. In all, 1% of patients required reintervention. Conclusions TCAR is a safe and effective treatment modality for carotid artery stenotic disease. Its outcomes are similar to historical results associated with carotid endarterectomy, long considered the gold standard.
Databáze: OpenAIRE