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TCAR and endarterectomy both ‘reasonable’ but stenting linked to worse outcomes in kidney disease patients
A study examining outcomes between different carotid revascularization procedures has concluded that transcarotid artery revascularization (TCAR) and carotid endarterectomy (CEA) both represent a “reasonable choice” in severe chronic kidney disease (CKD) and hemodialysis patients—but transfemoral carotid artery stenting (TF-CAS) appears…
Patient selection may explain ‘counterintuitive’ relationship between carotid stenting volume and outcomes in new study
High stroke and death rates relating to carotid stenting in the Pacific Northwest may be driven by the selection of high-risk patients with less than 80% stenosis, and reducing the frequency of stenting in this high-risk group—along with better adherence…
Boston Scientific announces agreement to acquire Silk Road Medical
Boston Scientific has announced that it has entered into a definitive agreement to acquire Silk Road Medical, a medical device company involved in producing products to be deployed during transcarotid artery revascularisation (TCAR). The purchase price is US$27.50 per share,…
CEA vs TCAR: Surgeons should be familiar with both procedures and ‘collaborate as needed’
When it comes to the ongoing debate of carotid endarterectomy (CEA) versus transcarotid artery revascularization (TCAR) in the treatment of carotid artery stenosis, operators should be comfortable and maintain experience with both of these procedures—and “collaborate as needed.” That is…
Single-center analysis suggests improved longer-term outcomes with endarterectomy versus TCAR
A large, single-center analysis has found that, despite parity between the two procedures in terms of perioperative clinical outcomes, carotid endarterectomy (CEA) was associated with a reduced rate of late stroke/death compared to transcarotid artery revascularization (TCAR). Writing in the…
ISC 2024 examines TCAR ‘explosion’ alongside advances in intensive medical therapy
This year’s International Stroke Conference (Feb. 7–9) in Phoenix, Arizona, hosted discussions on the current state of play in carotid stenosis treatment—and, most notably, advances that may erode the dominance of long-established carotid revascularization procedures in the U.S. Session moderator…
Coding: Increasing complexity and lost RVUs—a drop in the ocean?
A vascular surgery team at Audie L. Murphy VA Medical Center in San Antonio, Texas, uncovers “staggeringly low” numbers of correctly coded billing for three commonly performed vascular procedures, raising concerns over cases with more complex coding. Not long after…
Carotid stenting rebuttal: Those who live in glass houses…
Christopher J. White, MD, responds to a recent editorial by Malachi Sheahan III, MD, that took a critical look at the decision by the Centers for Medicare & Medicaid Services (CMS) to expand coverage for carotid artery stenting (CAS). I’m…
New survey shows transcarotid artery revascularization patients report faster recovery than their endarterectomy counterparts
This advertorial is sponsored by Silk Road Medical. For Scott Berman, MD, patient responses when confronted with an explanation of the extent of their asymptomatic carotid disease tend to be quite stark. They are either so petrified of having a…
Carotid disease: Getting to the right decision
The recent move by the Centers for Medicare & Medicaid Services (CMS) to expand coverage for carotid artery stenting brought with it the requirement for a shared decision-making interaction between physicians and patients as they establish which carotid revascularization treatment…