TCAR has ‘tremendous appeal’ as alternative to transfemoral carotid artery stenting

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Richard Powell, MD, from Lebanon, New Hampshire, talks to Vascular Specialist at the Society for Vascular Surgery’s Vascular Annual Meeting (SVS VAM; June 15–18) in Boston about his initial interest in the transcarotid artery revascularization (TCAR) procedure, noting that the benefit of TCAR is that “we are able to access the carotid artery without manipulating the arch” and the “tremendous appeal” of having embolic protection before crossing the lesion.

“Early on we were somewhat conservative with the patients we would offer it [TCAR] to. As time went by we saw the outcomes were good and we started to broaden the patients that we would treat,” says Powell.

The recent decision by the US Food and Drug Administration (FDA) to allow TCAR to be used in standard-risk surgical patients is “very interesting and appealing,” says Powell. For surgeons considering TCAR, Powell notes that the learning curve is “relatively short” and, in his experience, the procedure takes around half the time as that of a standard endarterectomy.

“The future of TCAR is promising,” says Powell, who concludes that the patient populations that should be addressed in the future “are those with low carotid lesions which are close to the clavicle, as well as patients with heavily calcified carotid lesions.”

This video is sponsored by Silk Road Medical.

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