Abstract
Transfemoral carotid artery stenting (TFCAS) was introduced as a minimally invasive option for high-risk patients not eligible for carotid endarterectomy. However, TFCAS was found to be associated with higher rates of perioperative stroke. This was attributed to the unprotected manipulation of the aortic arch and carotid atherosclerotic lesion. Therefore, transcarotid artery revascularization (TCAR) was introduced as a hybrid alternative to TFCAS. Prior studies have shown a significantly lower risk of perioperative stroke and death compared with TFCAS.
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