Recently, under the guidance of Vice President Han Jianfeng, Professor Yang Lin from Department of Vascular Surgery in Land Port District and Professor Yu Jia from Center for Cerebrovascular Diseases of the First Affiliated Hospital (FAH) of Xi’an Jiaotong University (XJTU) successfully completed the first case of transcarotid artery revascularization (TCAR) with reverse flow protection device in northwest China, providing minimally invasive revascularization treatment for high-risk patient who is ineligible for carotid artery stenting (CAS) and carotid endarterectomy (CEA).

Preoperative CTA showed severe stenosis of the left carotid artery complicated with mural thrombus. The patient had a risk of perioperative cerebral infarction and multiple primary diseases, failing to tolerate open surgery due to the risk of postoperative incisional infection and wound oozing. The cerebrovascular disease team from Department of Vascular Surgery and Department of Neurology conducted comprehensive preoperative evaluation. Under the guidance of Vice President Han Jianfeng, Professor Liu Jianlin, Professor Lu Shaoying and Professor Yang Lin from Department of Vascular Surgery, and Professor Yu Jia from Department of Neurology carried out multidisciplinary consultation and finally decided to employ TCAR to avoid the limitations of CEA and TFCAS. Professor Yang Lin from Department of Vascular Surgery served as the chief surgeon, assisted by Professor Yu Jia from Department of Neurology, attending physician Liu Chao from Department of Vascular Surgery, physician Liu Chang from Department of Anesthesiology, and the team from Interventional Operating Room, and successfully performed the surgery. The patient was discharged after proper recovery. Clinical application of TCAR not only represents FAH’s comprehensive treatment capability for complex carotid diseases, but also provides safer and more effective precise treatment options.

Traditional treatments of carotid artery stenosis include CAS and CEA, which have definite curative effects, whereas have indications and risks of their own. At present, international RCTs have confirmed that the incidence of stroke and complications of myocardial infarction related to TCAR is lower than those of traditional CAS and CEA, and it is one of the latest technologies for treating carotid artery stenosis. TCAR is a novel procedure combining the advantages of two conventional treatment options, which can reduce the risk of postoperative complications, especially ischemic stroke, shortens the operation time and improves the quality of postoperative recovery.

Although TCAR has been applied in a large quantity of clinical cases worldwide, it is still in preliminary stage in China, the first case of this kind in northwest China.