Feasibility and Utility of Intracranial Imaging During Transcarotid Artery Revascularization

Transcarotid artery revascularization (TCAR) is a validated option for carotid intervention in high risk patients. In the pivotal ROADSTER (safety and efficacy study for reverse flow used during carotid artery stenting procedure) trial, a finite (1.4%) incidence of intraprocedural cerebrovascular accidents (CVAs) was shown. TCAR is often performed using general anesthesia, which limits the capacity to assess the patient’s neurologic function intraoperatively. When performing transfemoral carotid artery stenting, intracranial imaging is performed before and after the intervention to identify any intraprocedural complications.