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George MJ, Husman R, Dakour-Aridi H, Tanaka A, Madison M, Motaganahalli R, Leckie K, Wang SK. Dual Institutional Experience with Transcarotid Artery Revascularization. Vasc Endovascular Surg 2022; 57:35-40. [DOI: 10.1177/15385744221127846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Mitchell J George
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Regina Husman
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Hanaa Dakour-Aridi
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Akiko Tanaka
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Mackenzie Madison
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Raghu Motaganahalli
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Katherin Leckie
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - S Keisin Wang
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
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Husman R, Tanaka A, Harlin SA, Martin GH, Saqib NU, Keyhani A, Keyhani K, Wang SK. Results Associated with the Health Systemwide Adoption of Transcarotid Revascularization. J Vasc Surg 2022; 76:967-972. [DOI: 10.1016/j.jvs.2022.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
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