Supervisors info:
Γεώργιος Γερουλάκος , Καθηγητής , Ιατρική Σχολή , ΕΚΠΑ
Ιωάννης Κακίσης, Καθηγητής, Ιατρική Σχολή , ΕΚΠΑ
Αχιλλέας Χατζηιωάννου, Καθηγητής, Ιατρική Σχολή , ΕΚΠΑ
Summary:
Introduction: Transcarotid stenting (TCAR) has been introduced as an alternative method to carotid endarterectomy (CEA) and carotid angioplasty stenting (CAS), especially when a patient presents with contraindications to the latter methods.
Aim: Aim of this study is to evaluate pooled data on patients undergoing TCAR.
Methodology: The present systematic review was conducted under the PRISMA guidelines. The following databases were utilized: Pubmed, Google Scholar, Scopus. All studies published between 1990 and April 2020 were investigated. Eligible studies should report 30-day mortality and cerebrovascular events rates in patients undergoing TCAR. The following key-words were utilized: transcarotid, transcervical and carotid stenting. Only series with >10 patients were included.
Results: In total, 17 studies including 4220 patients undergoing 4235 TCAR procedures were evaluated. 30-day mortality rate was 0,9%, 30-day stroke/TIA rate was 2,1% and 30-day stroke rate was 1,4%. Technical success was 98,2%. Cranial nerve injury was reported in 0,9% of cases (9 studies) while MI was detected only in 0,2% (16 studies). Moreover, the hematoma incidence was only 3,4%, with one third of these cases needing drainage. In a follow-up ranging from 3 to 40 months, a 11,2% restenosis rate was found.
Conclusions: In general, TCAR is associated with satisfying early and late outcomes, compared to CEA or CAS. An additional number of prospective comparative studies are needed for safer results.
