Evidence map›Paper›PMID 42734077›Full record

ArticleStroke2026

Transcarotid Artery Revascularization Versus Carotid Artery Stenting for Asymptomatic Carotid Stenosis.

Huanwen Chen, Dhairya A Lakhani, Marco Colasurdo, Jay Kakadiya, Matthew K McIntyre, Sridhara S Yaddanapudi, Mohamed A M Labib, Ajay Malhotra, Dheeraj Gandhi

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Huanwen ChenDepartment of Neurosurgery (H.C., M.A.M.L., D.G.), University of Maryland Medical Center, Baltimore.ORCID 0000-0003-2455-748X
Dhairya A LakhaniDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown (D.A.L., J.K.).ORCID 0000-0001-7577-1887
Marco ColasurdoDepartment of Interventional Radiology (M.C.), Oregon Health and Science University, Portland.ORCID 0000-0002-7823-3088
Jay KakadiyaDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown (D.A.L., J.K.).ORCID 0009-0009-2075-6562
Matthew K McIntyreDepartment of Neurological Surgery (M.K.M.I.), Oregon Health and Science University, Portland.ORCID 0009-0004-9788-5913
Sridhara S YaddanapudiDepartment of Neurology (H.C., S.S.Y.), University of Maryland Medical Center, Baltimore.
Mohamed A M LabibDepartment of Neurosurgery (H.C., M.A.M.L., D.G.), University of Maryland Medical Center, Baltimore.ORCID 0009-0000-2472-4482
Ajay MalhotraDepartment of Radiology, Yale New Haven Hospital, CT (A.M.).ORCID 0000-0001-9223-6640
Dheeraj GandhiDepartment of Neurosurgery (H.C., M.A.M.L., D.G.), University of Maryland Medical Center, Baltimore.ORCID 0000-0001-6741-5970

Funding

West Virginia IDEA-CTRU54GM104942 · NIGMS · WEST VIRGINIA UNIVERSITY · PI JUDITH FEINBERG · 2012 to 2026
$81.0M
NIGMS NIH HHS U54 GM104942
6 · The paper itself

Abstract

backgroundThe CREST-2 trial demonstrated superiority of carotid artery stenting (CAS) over intensive medical management for asymptomatic carotid stenosis, but it did not evaluate transcarotid artery revascularization (TCAR). Herein, we compared ischemic stroke outcomes between TCAR and CAS among patients with asymptomatic carotid stenosis in contemporary real-world practice.

methodsWe identified adults with asymptomatic carotid stenosis undergoing TCAR versus CAS using the 2016 to 2024 TriNetX database, which is a multicenter federated database of electronic health records. Propensity score matching was performed for demographics, laboratory values, risk factors, comorbidities, and medications. The primary outcome was ischemic stroke within 4 years.

resultsAmong 7303 identified patients, 2207 patients remained in each group after matching. TCAR did not demonstrate a significantly different stroke risk compared with CAS (hazard ratio, 0.68 [95% CI, 0.44-1.06]). The absolute risk difference was numerically but nonsignificantly lower for patients with TCAR throughout the follow-up period, progressively widening over time: 0.35% at 6 months (0.61% versus 0.96%;

conclusionsTCAR did not significantly lower stroke risk compared with CAS for asymptomatic carotid stenosis. Although nonsignificant trends towards lower stroke risk were observed for TCAR, the widening of absolute risk differences over time suggests residual confounding rather than potential procedural benefit.

Indexed as

carotid stenosisdemographyhemoglobinischemic strokerisk factors

Identifiers

PMID42734077
PMCPMC13592524

What Socratic holds

Textmetadata
Read underepoch 390

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.