Abstract WP268: Transcarotid Arterial Revascularization of Symptomatic Internal Carotid Artery Disease: A Systematic Review and Meta-Analysis

Malik Ghannam; Mohammad Almajali; Abdullah Al Qudah; Farid Khasiyev; Mahmoud Dibas; Dana Ghazaleh; Hannah Roeder; Nils Henninger; Adam H de Havenon; Colin P Derdeyn; Enrique C Leira; Seemant Chaturvedi; Shadi Yaghi

doi:10.1161/str.55.suppl_1.WP268

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Abstract WP268: Transcarotid Arterial Revascularization of Symptomatic Internal Carotid Artery Disease: A Systematic Review and Meta-Analysis

Malik Ghannam, Mohammad Almajali, Abdullah Al Qudah, Farid Khasiyev, Mahmoud Dibas, Dana Ghazaleh, Hannah Roeder, Nils Henninger, Adam H de Havenon, Colin P Derdeyn, …

Stroke (1970), Vol.55(Suppl_1)

02/2024

DOI: 10.1161/str.55.suppl_1.WP268

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Abstract

Abstract only Introduction: TCAR is an interventional therapy for symptomatic ICA disease. Currently, the utilization of TCAR is contentious due to limited evidence. We conducted a comprehensive systematic review and meta-analysis utilizing existing studies to evaluate the postoperative outcomes and complications of TCAR as compared to CAS and CEA for patients with symptomatic ICA disease. Methods: A systematic review was conducted, spanning from January 2000 to February 2023, encompassing studies that employed TCAR for the treatment of symptomatic ICA disease. The primary outcomes included 30-day combined stroke and transient ischemic attack (TIA), myocardial infarction (MI), and mortality. This was explained in Figure 1. Results: A total of seven studies involving 24,246 patients were analyzed. Compared to CAS, TCAR was associated with a similar rate of stroke and TIA (OR:0.77,95%CI:0.33-1.82), and MI (OR:1.29,95%CI:0.83-2.01) but lower mortality (OR:0.42,95%CI:0.22-0.81). In patients, ≥80 years, the rate of stroke and TIA was lower with TCAR compared to CAS (OR:0.47,95%CI:0.35-0.65). When compared to CEA, TCAR was associated with a higher rate of stroke and TIA (OR:1.26,95%CI:1.03-1.54) but without differing rates of MI (OR:0.9,95%CI:0.64-1.38), and mortality (OR:1.35,95%CI:0.87-2.10). this was explained in figure 2. Conclusions: Although CEA has traditionally been considered superior to stenting for symptomatic carotid stenosis, TCAR may have some advantages over CAS, particularly in the elderly population (≥80 years). Prospective randomized trials comparing the three modalities are needed.

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Title: Subtitle: Abstract WP268: Transcarotid Arterial Revascularization of Symptomatic Internal Carotid Artery Disease: A Systematic Review and Meta-Analysis
Creators: Malik Ghannam - University of Iowa
Mohammad Almajali - University of Iowa
Abdullah Al Qudah - University of Pittsburgh
Farid Khasiyev - Saint Louis University
Mahmoud Dibas - University of Iowa
Dana Ghazaleh - University of Iowa
Hannah Roeder - University of Iowa
Nils Henninger - University of Massachusetts Chan Medical School
Adam H de Havenon - University of Utah
Colin P Derdeyn - University of Iowa
Enrique C Leira - University of Iowa
Seemant Chaturvedi - University of Maryland, Baltimore
Shadi Yaghi - Brown University
Resource Type: Abstract
Publication Details: Stroke (1970), Vol.55(Suppl_1)
DOI: 10.1161/str.55.suppl_1.WP268
ISSN: 0039-2499
eISSN: 1524-4628
Language: English
Date published: 02/2024
Academic Unit: Neurology; Epidemiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984557945402771

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