[Current research progress of transcarotid artery revascularization in the treatment of carotid stenosis].

Transcarotid artery revascularization (TCAR) represents an innovative hybrid and minimally invasive technique, which is characterized by avoidance of aortic arch manipulation. With a specific blood flow-reversal device, TCAR redirects blood flow thereby minimizing the embolic risk during the whole treatment process of carotid stenosis. The risk of periprocedural stroke and death of patients who received TCAR is similar to those received carotid endarterectomy (CEA). However, the risk of myocardial infarction and cranial nerve injury is lower in TCAR population. In comparison with transfemoral carotid artery stenting, the risk of periprocedural stroke or death was significantly reduced in TCAR. The comprehensive therapeutic effect is similar between TCAR and CEA, but TCAR requires shorter procedural time. Despite these advantages, TCAR's clinical adoption requires more robust validation with large-scale prospective and multicenter randomized controlled trials to establish long-term efficacy and safety benchmarks. With ongoing technical refinements, TCAR may represent a key option for the transformation of carotid artery stenosis and therapeutic paradigm.