ArticleJournal of vascular surgery2022
Transcarotid artery revascularization is associated with similar outcomes to carotid endarterectomy regardless of patient risk status.
Article in Journal of vascular surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 35 citations in OpenAlex.
- Prospective, Multicenter Evaluation of Transcarotid Artery Revascularization in Standard-Risk Patients: 30-Day Outcomes of the ROADSTER 3 Study.Annals of neurology · 2026Article
- Article
- Three-year risk of stroke after transcarotid artery revascularization versus carotid endarterectomy among Medicare beneficiaries.Journal of vascular surgery · 2025Article
- Management and Treatment of Carotid Stenosis: Overview of Therapeutic Possibilities and Comparison Between Interventional Radiology, Surgery and Hybrid Procedure.Diagnostics (Basel, Switzerland) · 2025Review
- What the National Coverage Determination for Carotid Artery Stenting Means for the Treatment of Patients with Carotid Artery Disease.Annals of vascular surgery · 2025Review
- Using machine learning to predict outcomes following transcarotid artery revascularization.Scientific reports · 2025Article
- An International, Expert-Based Delphi Consensus Document on Controversial Issues about TransCarotid Artery Revascularization (TCAR).Annals of vascular surgery · 2025Article
- Seizures Following Carotid Endarterectomy: A Comprehensive Meta-Analysis of 69,479 Patients and Evidence-Based Recommendations for Perioperative Care.Diagnostics (Basel, Switzerland) · 2024Article
- Higher stroke risk after carotid endarterectomy and transcarotid artery revascularization is associated with relative surgeon volume ratio.Journal of vascular surgery · 2024Article
- An international, multispecialty, expert-based Delphi Consensus document on controversial issues in the management of patients with asymptomatic and symptomatic carotid stenosis.Journal of vascular surgery · 2024Review
- Optimal Cerebral Protection Confirmed by Transcranial Doppler During Transcarotid Artery Revascularization.Methodist DeBakey cardiovascular journal · 2024Article
- Automatic 1-year follow-up appointment creation and reminders can improve long-term follow-up after carotid revascularization.American journal of surgery · 2024Article
- Socioeconomic status fails to account for worse outcomes in non-Hispanic black patients undergoing carotid revascularization.Journal of vascular surgery · 2023Article
- Adoption and Diffusion of Transcarotid Artery Revascularization in Contemporary Practice.Circulation. Cardiovascular interventions · 2023Article
- Evaluation of the association between silent ischemic lesions and stent design in carotid stenting applications.Revista da Associacao Medica Brasileira (1992) · 2023Article
- Use of Transcarotid Artery Revascularization, Transfemoral Carotid Artery Stenting, and Carotid Endarterectomy in the US From 2015 to 2019.JAMA network open · 2022Article
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundCarotid artery stenting (CAS), including both transfemoral carotid artery stenting (TFCAS) and transcarotid artery revascularization (TCAR), reimbursement has been limited to high-risk patients by the Centers for Medicare & Medicaid Services (CMS) since 2005. We aimed to assess the association of CMS high-risk status with perioperative outcomes for carotid endarterectomy (CEA), TFCAS, and TCAR.
methodsWe performed a retrospective review of all Vascular Quality Initiative patients who underwent carotid revascularization between 2015 and 2020. Patients were stratified by whether they met CMS CAS criteria, and univariable and multivariable logistic regression analyses were performed to assess the association of procedure type (CEA, TFCAS, TCAR) with perioperative outcomes.
resultsOf 124,531 individuals who underwent carotid revascularization procedures, 91,687 (73.6%) underwent CEA, 17,247 (13.9%) underwent TFCAS, and 15,597 (12.5%) underwent TCAR. Among patients who met the CMS CAS criteria (ie, high-risk patients), the incidence of perioperative stroke was 2.7% for CEA, 3.4% for TFCAS, and 2.4% for TCAR (P < .001). Among standard-risk patients, the incidence of perioperative stroke was 1.7% for CEA, 2.7% for TFCAS, and 1.8% for TCAR (P < .001). After adjusting for baseline demographic and clinical characteristics, the odds of perioperative stroke were lower for TCAR versus CEA in high-risk patients (adjusted odds ratio [aOR], 0.82; 95% confidence interval [CI], 0.68-0.99) and similar in standard-risk patients (aOR, 1.05; 95% CI, 0.84, 1.31). In contrast, the adjusted odds of perioperative stroke were higher for TFCAS versus CEA in high-risk patients (aOR, 1.23; 95% CI, 1.03-1.46) and standard-risk patients (aOR, 1.60; 95% CI, 1.37-1.86). In both populations, TFCAS and TCAR patients had significantly lower odds of myocardial infarction than CEA patients (both P < .001).
conclusionsThe perioperative risks associated with CEA, TFCAS, and TCAR in high-risk patients support the current CMS criteria, although the risks associated with each revascularization approach in standard-risk patients suggest that distinguishing TCAR from TFCAS may be warranted.
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