Transcarotid Artery Revascularization for Carotid Artery Stenosis: A Case Report and Literature Review

doi:10.3969/j.issn.1673-5765.2025.09.013

Chinese Journal of Stroke ›› 2025, Vol. 20 ›› Issue (9): 1179-1185.DOI: 10.3969/j.issn.1673-5765.2025.09.013

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Transcarotid Artery Revascularization for Carotid Artery Stenosis: A Case Report and Literature Review

HOU Zhikai¹, HE Zijun¹, YU Tao², SHEN Chenyang³, WANG Rong², MA Ning¹

1 Department of Neurointervention Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
2 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
3 Department of Vascular Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

Received:2025-06-01 Revised:2025-09-03 Accepted:2025-09-05 Online:2025-09-20 Published:2025-09-20
Contact: MA Ning, E-mail: maning_03@hotmail.com

经颈动脉血运重建术治疗颈动脉狭窄1例并文献分析

侯志凯¹，何子骏¹，于洮²，沈晨阳³，王嵘²，马宁¹

1 北京 100070首都医科大学附属北京天坛医院介入神经病学科
2 首都医科大学附属北京天坛医院神经外科
3 首都医科大学附属北京天坛医院血管外科

通讯作者: 马宁 maning_03@hotmail.com
基金资助:
国家自然科学基金青年项目（82402235）
国家自然科学基金面上项目（82171894）

Abstract

Abstract: Carotid artery stenosis is a common cause of ischemic stroke. Carotid endarterectomy and carotid artery stenting are important intervention methods for patients with moderate-to-severe carotid artery stenosis. In recent years, transcarotid artery revascularization (TCAR) has emerged as a minimally invasive hybrid surgery that integrates the above two surgical methods, featuring both minimal invasiveness and brain protection functions. It mainly prevents and reduces the occurrence of cerebral embolism events by establishing a carotid-femoral venous reverse-flow circuit system. This paper reports the treatment process of a patient with carotid artery stenosis who underwent TCAR, and reviews the background, existing research results, and future directions of TCAR, aiming to enhance clinicians’ understanding and management of this technique.

Key words: Carotid artery stenosis; Ischemic stroke; Transcarotid artery revascularization

摘要： 颈动脉狭窄是缺血性卒中的常见病因。颈动脉内膜切除术和颈动脉支架植入术是中重度颈动脉狭窄患者的重要干预方式。近年来，新兴的经颈动脉血运重建术（transcarotid artery revascularization，TCAR）是一种微创复合手术，该手术将上述两种手术方式相结合，兼具微创性和脑神经保护功能，通过建立颈动脉-股静脉逆流管路系统预防和减少脑栓塞事件的发生。本文报道1例颈动脉狭窄患者行TCAR的治疗经过，回顾并讨论TCAR的产生背景、研究进展及未来的发展方向，旨在提升临床医师对TCAR的认知水平和临床应用能力。

关键词: 颈动脉狭窄; 缺血性卒中; 经颈动脉血运重建术

CLC Number:

HOU Zhikai, HE Zijun, YU Tao, SHEN Chenyang, WANG Rong, MA Ning. Transcarotid Artery Revascularization for Carotid Artery Stenosis: A Case Report and Literature Review[J]. Chinese Journal of Stroke, 2025, 20(9): 1179-1185.

侯志凯, 何子骏, 于洮, 沈晨阳, 王嵘, 马宁. 经颈动脉血运重建术治疗颈动脉狭窄1例并文献分析[J]. 中国卒中杂志, 2025, 20(9): 1179-1185.

References

[1] KLEINDORFER D O，TOWFIGHI A，CHATURVEDI S，et al. 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack：a guideline from the American Heart Association/American Stroke Association[J/OL]. Stroke，2021，52（7）：e364-e467[2025-07-20]. https://doi.org/10.1161/STR.0000000000000375.
[2] 中华医学会外科学分会血管外科学组. 颈动脉狭窄诊治指南[J]. 中华血管外科杂志，2017，5（2）：78-84. Vascular Surgery Group，Surgery Branch，Chinese Medical Association. Management of carotid artery stenosis：clinical practice guideline[J]. Chin J Vasc Surg，2017，5（2）：78-84.
[3] SCHNAUDIGEL S，GRÖSCHEL K，PILGRAM S M，et al. New brain lesions after carotid stenting versus carotid endarterectomy：a systematic review of the literature[J]. Stroke，2008，39（6）：1911-1919.
[4] KWOLEK C J，JAFF M R，LEAL J I，et al. Results of the ROADSTER multicenter trial of transcarotid stenting with dynamic flow reversal[J]. J Vasc Surg，2015，62（5）：1227-1234.
[5] DE BORST G J. Transcarotid artery revascularization[J/OL]. Br J Surg，2023，110：127-128[2025-07-20]. https://doi.org/10.1093/bjs/znac421.
[6] BROTT T G，CALVET D，HOWARD G，et al. Long-term outcomes of stenting and endarterectomy for symptomatic carotid stenosis：a preplanned pooled analysis of individual patient data[J]. Lancet Neurol，2019，18（4）：348-356.
[7] ROTS M L，MEERSHOEK A J A，BONATI L H，et al. Editor’s choice—predictors of new ischaemic brain lesions on diffusion weighted imaging after carotid stenting and endarterectomy：a systematic review[J]. Eur J Vasc Endovasc Surg，2019，58（2）：163-174.
[8] COELHO A，PRASSAPARO T，MANSILHA A，et al. Critical appraisal on the quality of reporting on safety and efficacy of transcarotid artery stenting with flow reversal[J]. Stroke，2020，51（9）：2863-2871.
[9] KASHYAP V S，SO K L，SCHNEIDER P A，et al. One-year outcomes after transcarotid artery revascularization（TCAR）in the ROADSTER 2 trial[J]. J Vasc Surg，2022，76（2）：466-473.
[10] MALAS M B，DAKOUR-ARIDI H，WANG G J，et al. Transcarotid artery revascularization versus transfemoral carotid artery stenting in the Society for Vascular Surgery Vascular Quality Initiative[J]. J Vasc Surg，2019，69（1）：92-103.
[11] SOLOMON Y，RASTOGI V，MARCACCIO C L，et al. Outcomes after transcarotid artery revascularization stratified by preprocedural symptom status[J]. J Vasc Surg，2022，76（5）：1307-1315.

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Transcarotid Artery Revascularization for Carotid Artery Stenosis: A Case Report and Literature Review

经颈动脉血运重建术治疗颈动脉狭窄1例并文献分析

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