Lu Jeffrey, McCabe Katey, Drucker Charlie, Blitzer David, Nagarsheth Khanjan, Toursavadkohi Shahab
Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, MD, USA.
Vasc Endovascular Surg. 2025 Feb;59(2):204-210. doi: 10.1177/15385744241285580. Epub 2024 Sep 18.
Surgical management of carotid stenosis has evolved from open carotid endarterectomy (CEA) to include multiple alternative procedures including transfemoral carotid artery stenting (tfCAS) and transcarotid artery stenting. In recent years, Transcarotid Artery Revascularization (TCAR) has emerged as a third option, combining open cut down to the common carotid artery (CCA) with endovascular stenting and neuroprotection via reversal of cerebral blood flow. In this case series, a modified TCAR procedure using a prosthetic conduit was successfully performed exclusively under local anesthesia in a total of 10 patients with carotid artery stenosis, high cardiac risk, and anatomical contraindications to a traditional TCAR.
