Compelling outcomes with TCAR versus CEA in patients with carotid artery stenosis published

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Silk Road Medical has announced that positive results from the ongoing TransCarotid Artery Revascularisation (TCAR) Surveillance Project,  comparing TCAR with carotid endarterectomy (CEA), have been published in Annals of Surgery.

“These results continue to show low in-hospital stroke, death, and combined stroke/death rates as well as statistically lower rates of in-hospital cranial nerve injury and in-hospital myocardial infarction compared to CEA,” says Mahmoud Malas (San Diego, USA), chief of vascular and endovascular surgery at UC San Diego Health.

He adds that “these promising outcomes will likely increase the role of TCAR in the management of carotid artery stenosis.”

The study evaluated patients who underwent carotid procedures between 2016 and 2019, with 6,384 patients in each group analysed using propensity score matching. TCAR was associated with significantly lower rates of in-hospital myocardial infarction (TCAR, 0.5%; CEA, 0.9%; p=0.005) as well as cranial nerve injury (TCAR, 0.4%; CEA, 2.7%, p<0.001).

Additionally, there were no statistical differences noted between TCAR and CEA for in-hospital stroke/death (TCAR, 1.6%; CEA, 1.6%, p=0.945) as well as stroke (TCAR, 1.4%; CEA, 1.4%, p=0.881) and death (TCAR, 0.4%; CEA, 0.3%; p=0.662). Patients receiving TCAR procedures were also less likely to stay in the hospital for more than one day (TCAR, 26.4%; CEA, 30.1%; p<0.001). At one year, the incidence of ipsilateral stroke or death was similar between the two groups [HR (95%CI):1.09(0.87–1.36), P=0.44].

“The publication of these data in the Annals of Surgery further validates the effectiveness of TCAR as a treatment option for patients with carotid artery disease, while highlighting the consistency of these data,” says Erica Rogers, Silk Road Medical’s chief executive officer.

The TCAR Surveillance Project, a key initiative of the Society for Vascular Surgery’s Vascular Quality Initiative (VQI)is an open-ended registry intended to compare real-world patient outcomes between TCAR and other alternatives.


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