TCAR “combines best of both worlds” but carotid endarterectomy “remains the gold standard”


Ali AbuRahma (Charleston, USA) moderates a panel for VEITHtv where he is joined by Mahmoud Malas (San Diego, USA) and Enrico Ascher (New York, USA), to discuss the differing strengths and downsides of transcarotid artery revascularisation (TCAR) and carotid endarterectomy (CEA).

Malas notes that while endarterectomy “remains the gold standard”, TCAR offers a hybrid procedure that “combines the best of both worlds”—endarterectomy and stenting, for those patients who are at high-risk for CEA.

Ascher says that carotid endarterectomy with a “mini incision”, which uses using ultrasound to limit the size of the incision to “about an inch”, has the benefit of not leaving behind a stent and makes the procedure cheaper, and safe.

The panel discusses patients who would be particularly suitable for TCAR, or endarterectomy; the concept of flow reversal and how more evidence needs to be gathered comparing TCAR with the small-incision version of endarterectomy.

This panel interview was filmed by VEITHtv at VEITHsymposium 2019 (19–23 November, New York, USA).

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