Transcarotid Artery Revascularization Set to Overtake Endarterectomy Procedures

Transcarotid artery revascularization (TCAR) allows for better outcomes in patients with high-risk factors, such as advanced age, previous neck surgery, or radiation therapy. Additionally, it has been shown to have long-term effectiveness in preventing stroke. As a result, the minimally invasive TCAR technique is set to overtake the traditional carotid endarterectomy procedures, according to GlobalData.
 
Silk Road Medical is the only TCAR device manufacturer. The innovation has driven growth in the carotid and renal artery stents (CRAS) sector, capturing an estimated 6.1% global market share in 2022, while industry heavyweights like Abbott Laboratories have lost significant share in CRAS since 2018.
 
“While Silk Road has a relatively smaller share of the CRAS market compared to large companies like Abbott and Boston Scientific, Silk Road’s position has steadily grown since the TCAR procedures were first implemented and in future, we may see the company become a much more dominant player,” GlobalData Medical Analyst Aidan Robertson said.
 
TCAR itself is a minimally invasive procedure used for treating carotid artery disease which uses a specialized tube to temporarily reverse blood flow inhibiting small portions of plaque that may break off from reaching the brain and prevent a stroke from happening. Following this, a soft, flexible stent is placed into the artery to widen it, stabilize the plaque build-up, and improve blood flow. 
 
Conversely, traditional endarterectomy is an open surgical procedure which makes an incision into the carotid artery and removes plaque to restore normal blood flow however, the large incision leaves behind a visible scar and carries risks of surgical complications one of which being stroke.
 
Another key difference between TCAR and endarterectomy procedures is that TCAR can be conducted using local anaesthesia while endarterectomy requires general anaesthesia which means patients undergoing TCAR may have shorter hospitals stays and recoveries.
 
“As a result of its minimally invasive methodology, TCAR reduces the risk of stroke and other complications compared to traditional endarterectomy and with a shorter recovery time,” Robertson said. “Given its advantages, it is no surprise that this procedure has shown major growth since its first implementation, and we may see TCAR become the primary treatment method for carotid artery disease with Silk Road Medical leading the way.”