Evidence map›Paper›PMID 39413993›Full record

ArticleAnnals of vascular surgery2025

An International, Expert-Based Delphi Consensus Document on Controversial Issues about TransCarotid Artery Revascularization (TCAR).

Kosmas I Paraskevas, Ali F AbuRahma, Christopher J Abularrage, Daniel G Clair, Jens Eldrup-Jorgensen, Vikram S Kashyap, Alan Dardik, Gert J de Borst, Meghan Dermody, Gianluca Faggioli and 19 more

Abstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of vascular surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Kosmas I ParaskevasDepartment of Vascular Surgery, Red Cross Hospital, Athens, Greece. Electronic address: paraskevask@hotmail.com.
Ali F AbuRahmaDepartment of Surgery, Charleston Area Medical Center/West Virginia University, Charleston, WV.
Christopher J AbularrageDivision of Vascular Surgery and Endovascular Therapy, Johns Hopkins Medical Institutions, Baltimore, MD.
Daniel G ClairDepartment of Vascular Surgery, Vanderbilt University Medical Center, Section of Surgical Sciences, Nashville, TN.
Jens Eldrup-JorgensenDivision of Vascular Surgery, Tufts University School of Medicine, Boston, MA.
Vikram S KashyapFrederik Meijer Heart and Vascular Institute, Corewell Health, Grand Rapids, MI.
Alan DardikDepartment of Surgery, Yale School of Medicine, New Haven, CT; Department of Surgery, VA Connecticut Healthcare System, West Haven, CT.
Gert J de BorstDepartment of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Meghan DermodyDivision of Vascular Surgery, Lancaster General Hospital, Lancaster, PA.
Gianluca FaggioliDepartment of Vascular Surgery, IRCSS Policlinico S. Orsola, Alma Mater Studiorum - Universita degli Studi di Bologna, Bologna, Italy.
Caitlin W HicksDivision of Vascular Surgery and Endovascular Therapy, Johns Hopkins Medical Institutions, Baltimore, MD.
Christopher J KwolekMass General Brigham Newton-Wellesley Hospital, Wellesley, MA.
Sean P LydenDepartment of Vascular Surgery, The Cleveland Clinic, Cleveland, OH.
Armando MansilhaFaculty of Medicine of the University of Porto, Porto, Portugal; Department of Angiology and Vascular Surgery, Hospital de S. Joao, Porto, Portugal.
Isabelle Van HerzeeleDepartment of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium.
Piotr MyrchaDepartment of General and Vascular Surgery, Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.
Jose Ignacio Leal LorenzoVascular Surgery and Interventional Radiology Unit, Clinica Universidad de Navarra, Madrid, Spain.
Jeffrey JimDepartment of Vascular & Endovascular Surgery, Allina Health Minneapolis Heart Institute, Minneapolis, MN.
Rodolfo PiniDepartment of Vascular Surgery, IRCSS Policlinico S. Orsola, Alma Mater Studiorum - Universita degli Studi di Bologna, Bologna, Italy.
Eric A SecemskySmith Center for Outcomes Research, Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA.
Francesco SpinelliVascular Surgery Division, Department of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy.
Laura CapocciaVascular and Endovascular Surgery Division, Department of Cardiovascular Sciences, SS Anna and Sebastiano Hospital, Caserta, Italy.
David H StoneSection of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
Michael C StonerDivision of Vascular Surgery, University of Rochester, Rochester, NY.
Clark J ZeebregtsDepartment of Surgery (Division of Vascular Surgery), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Brajesh K LalDepartment of Vascular Surgery, University of Maryland School of Medicine, Baltimore; Department of Vascular Surgery, Baltimore VA Medical Center, Baltimore; Department of Neurology, Mayo Clinic, Rochester, MN.
Peter A SchneiderDivision of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco, CA.
Mahmoud B MalasDepartment of Surgery, Division of Vascular and Endovascular Surgery, University of California San Diego, San Diego, CA.
Marc L SchermerhornDivision of Vascular Surgery, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA.

Funding

Risk Factors and Outcomes Associated with Late-Life Diabetic Peripheral NeuropathyK23DK124515 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI HICKS, CAITLIN WHITNEY · 2020 to 2024
$898k
NIDDK NIH HHS K23 DK124515
6 · The paper itself

Abstract

backgroundTranscarotid artery revascularization (TCAR) has emerged as an alternative therapeutic modality to carotid endarterectomy (CEA) and transfemoral carotid artery stenting (TFCAS) for the management of patients with carotid artery stenosis. However, certain issues regarding the indications and contraindications of TCAR remain unanswered or unresolved. The aim of this international, expert-based Delphi consensus document was to attempt to provide some guidance on these topics.

methodsA 3-round Delphi consensus process was performed, including 29 experts. The aim of round 1 was to investigate the differing views and opinions of the participants. Round 2 was carried out after the results from the literature on each topic were provided to the participants. During round 3, the participants had the opportunity to finalize their vote.

resultsMost participants agreed that TCAR can or can probably or possibly be performed within 14 days of a cerebrovascular event, but it is best to avoid it in the first 48 hr. It was felt that TCAR cannot or should not replace TFCAS or CEA, as each procedure has specific indications and contraindications. Symptomatic patients >80 years should probably be treated with TCAR rather than with TFCAS. TCAR can or can probably be used for the treatment of restenosis following CEA or TFCAS. Finally, there is a need for a randomized controlled trial (RCT) to provide better evidence for the unresolved issues.

conclusionsThis Delphi consensus document attempted to assist the decision-making of physicians or interventionalists or vascular surgeons involved in the management of carotid stenosis patients. Furthermore, areas requiring additional research were identified. Future studies and RCTs should provide more evidence to address the unanswered questions regarding TCAR.

Indexed as

Carotid StenosisClinical Decision-MakingDelphi TechniqueEndovascular ProceduresStentsEndarterectomy, CarotidHumansPatient SelectionRisk AssessmentRisk FactorsTime FactorsTreatment Outcome

Identifiers

PMID39413993
PMCPMC12439454

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.