Transcervical carotid artery stenting compared to transfemoral carotid artery stenting and carotid endarterectomy: perioperative and short-term results from a single center - Summary - MDSpire
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Transcervical carotid artery stenting compared to transfemoral carotid artery stenting and carotid endarterectomy: perioperative and short-term results from a single center
To compare the perioperative outcomes and six-month follow-up results among patients undergoing TC-CAS, TF-CAS, and CEA for carotid artery stenosis, highlighting the clinical significance of these comparisons.
Key Findings:
Perioperative stroke rates were low and comparable among all groups: TF-CAS 2.5%, TC-CAS 2.0%, CEA 1.1% (P = 0.802), indicating similar safety profiles.
Cranial nerve injury occurred exclusively in the CEA group, suggesting a potential risk associated with this method.
Six-month restenosis rates showed no significant difference: TF-CAS 3.7%, TC-CAS 2.0%, CEA 4.5% (P = 0.752), indicating comparable long-term outcomes.
No stroke or TIA events were observed in the TC-CAS group, highlighting its safety.
Hospital costs were significantly lower in the CEA group compared to TF-CAS and TC-CAS (P < 0.001), emphasizing cost-effectiveness.
Interpretation:
TC-CAS is a feasible and promising alternative to TF-CAS and CEA, offering favorable perioperative safety and short-term clinical outcomes, particularly for patients with high-risk anatomy due to its direct access and reduced embolic risk.
Limitations:
The study is retrospective and conducted at a single center, which may limit generalizability.
Longer-term studies are required to confirm sustained efficacy and assess potential long-term complications.
Conclusion:
TC-CAS offers a viable option for carotid artery stenosis treatment, especially in high-risk patients, but further research is necessary to validate these findings and explore long-term outcomes.
Over two days, specialists across neurology, neurosurgery and related subspecialties came together to discuss advances in stroke care, epilepsy, movement disorders, neurodegenerative disease, neuro-oncology, brain and spine surgery, interventional pain management and emerging technologies.
