This systematic review and meta-analysis compared trans-carotid artery revascularization (TCAR) as an alternative approach to carotid endarterectomy (CEA) in patients with carotid artery disease. An electronic search was conducted using PubMed, Scopus, and Cochrane databases including comparative studies with patients who underwent either TCAR or CEA. This meta-analysis is according to the recommendations of the PRISMA statement. Eight studies met our eligibility criteria, incorporating 7,606 and 7,048 patients in the TCAR and CEA groups, respectively. Thirty-day mortality (odds ratio [OR]: 0.94, 95% confidence interval [CI]: 0.56–1.56, P = .81) and stroke (OR: 0.92, 95%CI 0.70–1.22, P = .57) were similar between the two groups, with low heterogeneity. The odds of myocardial infarction (OR: 1.79, 95% CI: 1.18–2.71, P = .01) and cranial nerve injury were significantly higher in patients undergoing CEA compared with TCAR (OR: 4.11, 95% CI: 2.59–6.51, P < .001). The subgroup analysis according to symptomatic pre-intervention status revealed no statistically significant difference regarding 30-day mortality (symptomatic OR: 0.91, 95% CI: 0.40–2.07, P = .82, asymptomatic OR: 0.93, 95% CI: 0.46–1.86, P = .83) and stroke (symptomatic OR: 0.88, 95% CI:0.47–1.64, P = .68, asymptomatic OR: 0.93, 95% CI: 0.64–1.35, P = .70). TCAR offers an alternative treatment for patients with carotid artery stenosis with comparable to CEA mortality and stroke rates during a 30-day post-operative period.

中文翻译：

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颈动脉疾病患者的经颈动脉血运重建与颈动脉内膜切除术：30 天结果的系统回顾和荟萃分析

这项系统评价和荟萃分析比较了颈动脉疾病患者中经颈动脉血运重建术 (TCAR) 作为颈动脉内膜切除术 (CEA) 的替代方法。使用 PubMed、Scopus 和 Cochrane 数据库进行电子检索，包括与接受 TCAR 或 CEA 的患者进行比较研究。本荟萃分析是根据 PRISMA 声明的建议进行的。八项研究符合我们的资格标准，分别纳入 TCAR 组和 CEA 组的 7,606 名患者和 7,048 名患者。三十天死亡率（比值比 [OR]：0.94，95% 置信区间 [CI]：0.56–1.56，P = .81）和卒中（OR：0.92，95% CI 0.70–1.22，P = .57）两组之间相似，异质性较低。与 TCAR 相比，接受 CEA 的患者发生心肌梗死（OR：1.79，95% CI：1.18–2.71，P = 0.01）和颅神经损伤的几率显着更高（OR：4.11，95% CI：2.59–6.51， P < .001)。根据干预前症状状态进行的亚组分析显示，30 天死亡率没有统计学显着差异（有症状 OR：0.91，95% CI：0.40–2.07，P = 0.82，无症状 OR：0.93，95% CI：0.46– 1.86，P = .83）和中风（有症状 OR：0.88，95% CI：0.47–1.64，P = .68，无症状 OR：0.93，95% CI：0.64–1.35，P = .70）。 TCAR 为颈动脉狭窄患者提供了一种替代治疗，其术后 30 天的死亡率和中风率与 CEA 相当。