[Perioperative outcomes of patients with carotid artery stenosis received transcarotid artery revascularization and analysis of factors related to intraprocedural plaque debris capture].

Objective: To investigate the perioperative outcomes of transcarotid artery revascularization (TCAR) in patients with carotid artery stenosis and analyze the related factors of intraprocedural plaque debris capture. Methods: Clinical data from 56 patients who underwent TCAR for carotid artery stenosis at Zhongshan Hospital, Fudan University was retrospectively collected between September 2024 and August 2025. Follow-up were conducted for the patients on the day of surgery, 3 days, 1 week, 2 weeks, and 1 month after surgery through outpatient or inpatient settings. The analysis focused on technical success rates and perioperative complication incidence. Firth's penalized maximum likelihood estimation for multivariable logistic regression analyses were used to screen the risk factors related to plaque debris capture in the reverse-flow device during TCAR procedures. Results: Among the 56 patients aged (70±7) years, 50 were male and 6 were female. The surgical technique achieved a 100% (56/56) success rate with a perioperative complication rate of 1.8% (1/56). All patients [M(Q1, Q3)] had the procedure duration of 95 (80, 141) minutes and the positive arterial blood flow occlusion time of 8 (7, 10) minutes. A total of 40 patients registered the situation of plaque debris capture. Reverse-flow device capture of plaque debris was confirmed in 50% (20/40) of patients following TCAR procedures. Multivariate logistic regression analysis demonstrated that symptomatic patients (OR=15.89, 95%CI: 1.96-257.81) and residual lumen diameter at the narrowest-point (OR=0.20, 95%CI: 0.04-0.63) were the related risk factors for plaque debris capture during TCAR procedures. Conclusions: In patients with carotid artery stenosis, TCAR achieved a high technical success rate with few perioperative complications. Symptomatic patients and residual lumen diameter at the narrowest-point were the related factors for plaque debris capture.