Why the study?
No randomized trial evaluating TCAR has been performed to date, and previous reports comparing it to CEA and TF-CAS have important limitations.
Does transcarotid artery revascularization (TCAR) reduce perioperative and 1-year stroke or death compared to carotid endarterectomy (CEA) and transfemoral carotid artery stenting (TF-CAS) in patients with carotid artery stenosis?
Population
21 234 TCAR, 82 737 CEA, and 14 595 TF-CAS patients across 662 centers
Comparison
TCAR vs CEA vs TF-CAS
Design
Registry-based instrumental variable cohort study
Follow-up
1 year
Authors
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Registry data link TCAR to higher perioperative stroke/death than CEA; leaves open whether RCTs will confirm 1-year equivalence.
Does transcarotid artery revascularization (TCAR) reduce perioperative and 1-year stroke or death compared to carotid endarterectomy (CEA) and transfemoral carotid artery stenting (TF-CAS) in patients with carotid artery stenosis?
TCAR appears to be a safe alternative to CEA with comparable 1-year outcomes, and performs favorably compared to TF-CAS, particularly in symptomatic patients.
Columbo et al. (2022) studied this question.
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