Clinical Scorecard: Comparison of Perioperative and Short-Term Outcomes in Transcervical Carotid Artery Stenting, Transfemoral Carotid Artery Stenting, and Carotid Endarterectomy: Findings from a Single-Center Study

At a Glance

Key Highlights

• Perioperative stroke rates were low and comparable among TC-CAS, TF-CAS, and CEA groups.
• Cranial nerve injury occurred exclusively in the CEA group.
• No stroke or TIA events observed in the TC-CAS group at six-month follow-up.
• Hospital costs were significantly lower in the CEA group compared to TF-CAS and TC-CAS.
• TC-CAS is a feasible alternative for patients with high-risk anatomy.

Guideline-Based Recommendations

Diagnosis

• Patients with symptomatic carotid stenosis ≥ 50% or asymptomatic stenosis ≥ 70% based on imaging.

Management

• Standardized medical therapy including antiplatelet agents and statins before procedures.

Monitoring & Follow-up

• Assess perioperative stroke and complications; evaluate six-month restenosis and stroke/TIA events.

Risks

• Risks of anesthesia-related complications in CEA; embolic risks in TF-CAS.

Patient & Prescribing Data

220 patients undergoing carotid revascularization from 2020 to 2024.

TC-CAS is suitable for patients with hostile aortic arches or difficult transfemoral access.

Clinical Best Practices

• Perform procedures under general anesthesia with experienced vascular surgeons.
• Utilize appropriate imaging techniques for diagnosis and assessment of stenosis.
• Consider patient anatomy and comorbidities when selecting revascularization strategy.

Related Resources & Content

• Study on carotid artery stenosis prevalence
• Long-term efficacy of CEA
• Embolic risks in transfemoral CAS