The Role of Carotid Graft Interposition During Elective and Emergent Interventions: A Scoping Review Protocol (Preprint)

BACKGROUND In a significant proportion of carotid interventions, carotid graft replacement is required to achieve a successful outcome both as primary method or as bail-out solution. An exhaustive mapping of the sparse and heterogeneous evidence available in the literature may provide a more comprehensive understanding of this topic. OBJECTIVE This scoping review aims to examine and summarize the evidence from scientific literature concerning the role of graft interposition during elective and emergent carotid interventions. METHODS This scoping review will be conducted following recommendations outlined by Levac et al and will adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews) guidelines for reporting. Peer-reviewed papers written in English will be searched in the following databases: PubMed/MEDLINE, Embase, Scopus, and Web of Science. The web-based systematic review platform Rayyan will be used to create a data extraction template. It will cover the following items: elective carotid endarterectomy, emergent carotid endarterectomy, carotid artery restenosis, carotid artery trauma, carotid artery aneurysm, carotid artery dissection, carotid patch infection, internal carotid artery fibrosis, carotid artery tumour. All study designs (RCTs, observational, case series) will be considered. Non-English studies, animal studies, cadaveric/anatomical-only reports, purely technical notes without clinical data. An data regarding extracranial-to-intracranial bypass will be excluded. Study selection based on title and abstract screening (first stage), full-text review (second stage), and data extraction (third stage) will be performed by a group of researchers, whereby each paper will be reviewed by at least 2 people. Any conflict regarding the inclusion or exclusion of a study and the data extraction will be resolved by discussion between the researchers who evaluated the papers; a third researcher will be involved if consensus is not reached. RESULTS A preliminary search of PubMed/MEDLINE, Embase, Scopus, and Web of Science was conducted, and no current or ongoing systematic reviews or scoping reviews on the topic were identified. The results of the study are expected in July 2026 CONCLUSIONS Our scoping review will seek to provide an overview of the available evidence and identify research gaps regarding the role of graft interposition during elective and emergent carotid interventions.