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- Publisher Website: 10.1016/j.avsg.2019.11.001
- Scopus: eid_2-s2.0-85076578077
- PMID: 31705988
- WOS: WOS:000521506600052
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Article: Transcarotid artery revascularization as a new modality of treatment for cartoid stenosis
Title | Transcarotid artery revascularization as a new modality of treatment for cartoid stenosis |
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Authors | |
Keywords | carotid artery carotid artery obstruction carotid artery stenting cerebrovascular accident clinical outcome |
Issue Date | 2020 |
Publisher | Elsevier Inc. |
Citation | Annals of Vascular Surgery, 2020, v. 64, p. 397-404 How to Cite? |
Abstract | Background:
Carotid artery stenosis is a significant cause of ischemic stroke, and studies have shown that transfemoral carotid artery stenting is associated with a higher perioperative stroke risk than open endarterectomy. Transcarotid artery revascularization (TCAR) is a novel technique in carotid stenting via direct transcervical carotid access without the risk of arch manipulation, offers a smaller wound compared with endarterectomy, and employs flow reversal to decrease the risk of antegrade embolic stroke. Contemporary evidence on the safety and efficacy of TCAR is reviewed.
Methods:
A systematic literature review on TCAR from January 2009 to August 2019 was performed in PubMed and EMBASE databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Clinical studies on TCAR with flow reversal with clinical outcomes of stroke, myocardial infarction (MI), and death were included.
Results:
Initial search of the literature yielded 161 articles, of which 8 studies were included comprising of 5 single-arm studies and 3 comparative studies. Studies demonstrated high technical success rates of TCAR from 90.6% to 100%, with low perioperative stroke, MI, and mortality rates of 0 to 4%, 0 to 0.7% and 0 to 2.7%, respectively. TCAR was significantly associated with a lower in-hospital stroke/transient ischemic attack rate when compared to transfemoral carotid stenting. There was no significant difference in perioperative stroke/MI/death when compared to endarterectomy although TCAR had a significantly lower risk of cranial nerve injury.
Conclusions:
TCAR with flow reversal is a promising treatment option for carotid occlusive disease. Clinical trials are currently underway to provide a better report on outcomes of TCAR and for further comparison between TCAR and carotid endarterectomy. |
Persistent Identifier | http://hdl.handle.net/10722/283393 |
ISSN | 2023 Impact Factor: 1.4 2023 SCImago Journal Rankings: 0.616 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Luk, Y | - |
dc.contributor.author | Chan, YC | - |
dc.contributor.author | Cheng, SWK | - |
dc.date.accessioned | 2020-06-22T02:55:51Z | - |
dc.date.available | 2020-06-22T02:55:51Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Annals of Vascular Surgery, 2020, v. 64, p. 397-404 | - |
dc.identifier.issn | 0890-5096 | - |
dc.identifier.uri | http://hdl.handle.net/10722/283393 | - |
dc.description.abstract | Background: Carotid artery stenosis is a significant cause of ischemic stroke, and studies have shown that transfemoral carotid artery stenting is associated with a higher perioperative stroke risk than open endarterectomy. Transcarotid artery revascularization (TCAR) is a novel technique in carotid stenting via direct transcervical carotid access without the risk of arch manipulation, offers a smaller wound compared with endarterectomy, and employs flow reversal to decrease the risk of antegrade embolic stroke. Contemporary evidence on the safety and efficacy of TCAR is reviewed. Methods: A systematic literature review on TCAR from January 2009 to August 2019 was performed in PubMed and EMBASE databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Clinical studies on TCAR with flow reversal with clinical outcomes of stroke, myocardial infarction (MI), and death were included. Results: Initial search of the literature yielded 161 articles, of which 8 studies were included comprising of 5 single-arm studies and 3 comparative studies. Studies demonstrated high technical success rates of TCAR from 90.6% to 100%, with low perioperative stroke, MI, and mortality rates of 0 to 4%, 0 to 0.7% and 0 to 2.7%, respectively. TCAR was significantly associated with a lower in-hospital stroke/transient ischemic attack rate when compared to transfemoral carotid stenting. There was no significant difference in perioperative stroke/MI/death when compared to endarterectomy although TCAR had a significantly lower risk of cranial nerve injury. Conclusions: TCAR with flow reversal is a promising treatment option for carotid occlusive disease. Clinical trials are currently underway to provide a better report on outcomes of TCAR and for further comparison between TCAR and carotid endarterectomy. | - |
dc.language | eng | - |
dc.publisher | Elsevier Inc. | - |
dc.relation.ispartof | Annals of Vascular Surgery | - |
dc.subject | carotid artery | - |
dc.subject | carotid artery obstruction | - |
dc.subject | carotid artery stenting | - |
dc.subject | cerebrovascular accident | - |
dc.subject | clinical outcome | - |
dc.title | Transcarotid artery revascularization as a new modality of treatment for cartoid stenosis | - |
dc.type | Article | - |
dc.identifier.email | Chan, YC: ycchan88@hkucc.hku.hk | - |
dc.identifier.email | Cheng, SWK: swkcheng@hku.hk | - |
dc.identifier.authority | Chan, YC=rp00530 | - |
dc.identifier.authority | Cheng, SWK=rp00374 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/j.avsg.2019.11.001 | - |
dc.identifier.pmid | 31705988 | - |
dc.identifier.scopus | eid_2-s2.0-85076578077 | - |
dc.identifier.hkuros | 310358 | - |
dc.identifier.volume | 64 | - |
dc.identifier.spage | 397 | - |
dc.identifier.epage | 404 | - |
dc.identifier.isi | WOS:000521506600052 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0890-5096 | - |