Carotid Artery Stenting

in Carotid and Cerebrovascular Disease

Applied

Type

Addition

Confidence

90%

Created

Mar 19, 2026

Evidence

2 sources

Rationale

The section was updated to include Transcarotid Artery Revascularization (TCAR), which has become a standard alternative to traditional transfemoral CAS. The addition of a systematic review (Liapis 2026) and a large decade-long cohort study (Kenny 2025) provides high-quality evidence for the safety and durability of this technique. Abbreviations were expanded as per the style guide.

Evidence

Liapis CD et al. The role of transcarotid artery revascularization in symptomatic carotid stenosis. International Angiology. 2026. PMID: 40859894.
Verified source
PubMedDOI
Kenny M et al. Outcomes and insights from a decade of transcarotid artery revascularization in community practice. Journal of Vascular Surgery. 2025. PMID: 40348294.
Verified source
PubMedDOI

Content Changes

* Minimally invasive alternative.alternative to carotid endarterectomy (CEA).
* **CREST (2010):** [[carotid endarterectomy (CEA)]] vs [[carotid artery stenting (CAS)]] → no difference in long-term stroke/MI/death,stroke/myocardial infarction (MI)/death, but [[CAS]] had higher peri-procedural stroke, lower MI [@crest2010].
* **ICSS (2010):** higher peri-procedural stroke with [[CAS]].
* Indications: high surgical risk, restenosis after [[CEA]], radiation-induced stenosis.
* Embolic protection devices (EPD) are strongly recommended.recommended for transfemoral CAS.
* **Transcarotid Artery Revascularization (TCAR):** A hybrid approach utilizing direct carotid access and dynamic flow reversal for embolic protection. Systematic reviews support the role of TCAR in managing symptomatic carotid stenosis [@liapis2026]. Long-term data from a decade of community practice demonstrate that TCAR provides durable outcomes and a favorable safety profile [@kenny2025].
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