Evaluation of Staged TCAR and Cardiac Surgery or Structural Heart Intervention

Introduction: The optimal treatment strategy for patients with concomitant carotid and cardiac disease remains controversial. Transcarotid artery revascularization stenting with reversed flow protection (TCAR) has achieved results equivalent to carotid endarterectomy (CEA) in high risk patients. Met...

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Bibliographic Details
Published in:Vascular and endovascular surgery 2021-10, Vol.55 (7), p.702-705
Main Authors: Almenoff, Maxwell, Garrett, H. Edward
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Carotid Artery Diseases - diagnostic imaging
Carotid Artery Diseases - physiopathology
Carotid Artery Diseases - therapy
Coronary Artery Bypass - adverse effects
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - physiopathology
Coronary Artery Disease - surgery
Databases, Factual
Endovascular Procedures - adverse effects
Endovascular Procedures - instrumentation
Female
Heart Valve Diseases - diagnostic imaging
Heart Valve Diseases - physiopathology
Heart Valve Diseases - surgery
Heart Valve Prosthesis Implantation - adverse effects
Humans
Male
Middle Aged
Retrospective Studies
Stents
Time Factors
Transcatheter Aortic Valve Replacement
Treatment Outcome
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Summary:Introduction: The optimal treatment strategy for patients with concomitant carotid and cardiac disease remains controversial. Transcarotid artery revascularization stenting with reversed flow protection (TCAR) has achieved results equivalent to carotid endarterectomy (CEA) in high risk patients. Methods: A retrospective review of all patients at a single center who received staged TCAR prior to cardiac intervention was performed. Results: 37 patients underwent 42 TCAR procedures prior to cardiac intervention (25 requiring open cardiac surgery and 12 requiring percutaneous intervention). There were no myocardial or neurological complications following TCAR prior to cardiac intervention. Three patients (8%) developed a neck hematoma which required evacuation. Conclusion: A staged approach to combined carotid and cardiac pathology with TCAR prior to cardiac intervention appears to be a safe and effective strategy.
ISSN:1538-5744
1938-9116
DOI:10.1177/15385744211017704