Transcervical carotid artery stenting compared to transfemoral carotid artery stenting and carotid endarterectomy: perioperative and short-term results from a single center.

Background: Carotid artery stenosis is a major cause of ischemic stroke. Various revascularization strategies exist, including Carotid Endarterectomy (CEA), Transfemoral Carotid Artery Stenting (TF-CAS), and Transcervical Carotid Artery Stenting (TC-CAS). This study aimed to compare the perioperative outcomes and six-month follow-up results among patients undergoing TC-CAS, TF-CAS, and CEA for carotid artery stenosis. Methods: A retrospective analysis was performed on 220 patients undergoing carotid revascularization from 2020 to 2024. Patients were divided into three groups: TC-CAS (50), TF-CAS (81), and CEA (89). Primary endpoints included perioperative stroke and complications; secondary endpoints assessed six-month restenosis and stroke/TIA events. Results: Perioperative stroke rates were low and comparable among all groups (TF-CAS 2.5%, TC-CAS 2.0%, CEA 1.1%; Conclusion: TC-CAS is a feasible and promising alternative to TF-CAS and CEA, offering favorable perioperative safety and short-term clinical outcomes. It is particularly suitable for patients with high-risk anatomy, but longer-term studies are required to confirm sustained efficacy.