Peer Reviewed Content

The Application Of Transcarotid Artery Revascularization For Treatment Of Carotid Artery Stenosis

Author: Matthew Scherschel, DMSc, MPAS, MHA, RRT, PA-C

Abstract

Carotid artery stenosis can present a risk for transient ischemic attack and stroke. Treatment of carotid artery stenosis with carotid endarterectomy is considered the gold standard but may not be the best treatment option in patients at high-risk for surgical intervention. Transfemoral carotid artery stenting was introduced as a minimally invasive treatment option but has demonstrated poor outcomes compared to carotid endarterectomy. The introduction of transcarotid artery revascularization fills this role by providing outcomes superior to transfemoral carotid artery stenting and consistent with carotid endarterectomy supporting its application for treatment of carotid artery stenosis in patients at high-risk for surgical intervention.

Keywords: carotid artery stenosis, carotid endarterectomy, transcarotid artery revascularization, transfemoral carotid artery stenting, vascular surgery

Learning objectives

• Define symptomatic and asymptomatic carotid artery stenosis.

• Distinguish Centers for Medicare and Medicaid Services guidelines for patients at high-risk for carotid endarterectomy.

• Describe the procedure of transcarotid artery revascularization.

• Recognize patients needing intervention for carotid artery stenosis and recommend treatment based on their clinical picture.