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Safety and efficacy of transcarotid artery revascularization in a community hospital.

Authors
  • Zebolsky, Aaron L1
  • Chou, Jesse1
  • Key, Phillip1
  • Knight, Patrick1
  • Mahmood, Gulrez1
  • Jain, Krishna2
  • Rummel, Mark3
  • 1 Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Mich.
  • 2 Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Mich. Electronic address: [email protected]
  • 3 Advanced Vascular Surgery at Kalamazoo, Kalamazoo, Mich.
Type
Published Article
Journal
Journal of vascular surgery
Publication Date
Jul 01, 2021
Volume
74
Issue
1
Pages
203–208
Identifiers
DOI: 10.1016/j.jvs.2020.12.066
PMID: 33348008
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

We evaluated the outcomes and complications of transcarotid artery revascularization (TCAR) outside of academic vascular surgery programs. An institutional review board-approved retrospective study was performed. Data from all cases of TCAR performed at a community hospital from May 2017 to February 2020 were collected and analyzed. Seven vascular surgeons performed the procedures after receiving appropriate training. The primary outcomes included technical success, the need for further revascularization, and major adverse events (death, cerebrovascular accident [CVA], myocardial infarction). The secondary outcomes included other adverse events and complications. The outcomes were assessed in the perioperative and 30-day follow-up periods. During a 33-month period, TCAR was completed in 147 of 149 attempted cases (98.7%). No patients required further revascularization. The perioperative and 30-day major adverse event rates were 0.7% (n = 1) and 3.4% (n = 5), respectively. One case of a minor perioperative CVA occurred. At 30 days, one patient had died. The 30-day complications included CVA (n = 1) and myocardial infarction (n = 3). The combined perioperative and 30-day minor complication rates were 2.7% and 1.4%, respectively. TCAR is a safe and effective method of carotid artery revascularization in a community hospital setting. This technology might help improve revascularization in patients without access to larger academic centers. Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

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