Transcarotid Artery Revascularization for Carotid Artery Disease

Enrolling by invitation at 43 trial locations
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Silk Road Medical
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to understand the long-term effects of the ENROUTE Transcarotid Stent System and Neuroprotection System for individuals with blockages in their carotid arteries, which are critical blood vessels in the neck. The focus is on those with symptoms or risk factors related to these blockages, such as noticeable narrowing in the artery. Participants should have already been part of the initial ROADSTER 3 study and completed their required follow-up. This trial suits individuals who have experienced symptoms like dizziness or vision issues due to carotid artery problems and wish to contribute to research on improving future treatments. As a Phase 4 trial, this research explores how the already FDA-approved treatment benefits more patients.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that the ENROUTE Transcarotid Stent System and Neuroprotection System are safe for carotid artery revascularization?

Research has shown that Transcarotid Artery Revascularization (TCAR) is generally well-tolerated. In a large study of over 142,000 patients, TCAR significantly lowered the risk of death within 30 days after the procedure. However, the risk of stroke or death shortly after TCAR was higher compared to carotid endarterectomy, another surgical option. Another study showed that the risk of major issues like death, stroke, or heart attack was relatively low, at 0.7% immediately after the procedure and 3.4% within 30 days.

While some patients experienced a stroke within 30 days, these cases were relatively rare, occurring in about 1.68% of patients. Long-term results indicated that the risk of having a stroke on the treated side of the neck was similar to other procedures over a year. Overall, TCAR has been linked to a low rate of serious complications, making it a promising option for those needing treatment for carotid artery issues.12345

Why are researchers excited about this trial?

Researchers are excited about carotid artery revascularization for standard-risk patients because it offers a less invasive option compared to traditional surgical methods like carotid endarterectomy. This technique is particularly appealing as it involves placing a stent to widen the narrowed artery, which can lower the risk of stroke in patients with carotid artery disease. Additionally, this method can be performed with a small incision, potentially reducing recovery time and complications associated with open surgery. The ability to treat both symptomatic and asymptomatic patients with a precise, targeted approach makes this treatment stand out in the field of vascular interventions.

What evidence suggests that the ENROUTE Transcarotid Stent System and Neuroprotection System are effective for carotid artery revascularization?

Research has shown that Transcarotid Artery Revascularization (TCAR) effectively treats carotid artery stenosis, a condition where neck arteries narrow. Studies have found that TCAR poses a lower risk of causing a stroke during the procedure compared to traditional methods. It also typically takes less than an hour and has a reduced risk of damaging the nerves controlling facial movement and sensation. Although TCAR may carry a slightly higher risk of stroke or temporary mini-stroke compared to carotid endarterectomy (another surgery for blocked arteries), it remains a good option due to its general safety and efficiency. These findings suggest TCAR reliably prevents strokes by improving blood flow in the neck's arteries.36789

Who Is on the Research Team?

MS

Marc Schermerhorn, MD

Principal Investigator

Beth Israel Deaconess Medical Center

JJ

Jeffrey Jim, MD

Principal Investigator

Abbott Northwestern Minneapolis Heart Institute Foundation

MD

Meghan Dermody, MD

Principal Investigator

Lancaster General Hospital

Are You a Good Fit for This Trial?

Inclusion Criteria

I was part of the ROADSTER 3 study and received treatment with ENROUTE TSS and NPS.
I can understand and agree to the study's procedures and risks.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants underwent carotid revascularization with the ENROUTE Transcarotid Stent System and Neuroprotection System

Not specified

Follow-up

Participants are monitored for long-term outcomes including ipsilateral stroke and in-stent restenosis

5 years

What Are the Treatments Tested in This Trial?

Interventions

  • Transcarotid Artery Revascularization

How Is the Trial Designed?

1

Treatment groups

Experimental Treatment

Group I: Standard-risk patients who underwent carotid interventionExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Silk Road Medical

Lead Sponsor

Trials
10
Recruited
1,900+

Citations

Outcomes of transcarotid artery revascularization

TCAR is associated with a lower risk of perioperative stroke compared to TFCAS. TCAR is also associated with shorter operative time, lower risk of CNI and less ...

A Systematic Review and Study-Level Meta-Analysis | Stroke

Compared with CEA, TCAR was associated with a higher rate of stroke or transient ischemic attack (OR, 1.26 [95% CI, 1.03–1.54]) but similar ...

Outcomes and insights from a decade of transcarotid artery ...

TCAR is an effective and efficient first-line therapy for treating carotid artery stenosis, regularly performed in less than 1 hour.

Use of TCAR, TFCAS, and CEA in the US From 2015 to 2019

This cohort study examines the pattern of use, outcomes, and patient and disease factors associated with transcarotid artery ...

a systematic review and network meta-analysis

We provide a comprehensive comparison of the safety, efficacy, and long-term outcomes associated with carotid endarterectomy (CEA), carotid ...

6.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/40967268/

Comparative Safety and Efficacy of Transcarotid Artery ...

Results: Thirteen studies involving 142,032 patients were included in the analysis. TCAR significantly reduced 30-day mortality (RR 0.45; p< ...

Perioperative and 1‐Year Rates of Stroke or Death

Perioperative stroke or death was greater following TCAR when compared with carotid endarterectomy. At 1 year, there was no statistically ...

Safety and efficacy of transcarotid artery revascularization ...

The perioperative and 30-day major adverse event (death, stroke, myocardial infarction) rates were 0.7% and 3.4%, respectively. •. Take Home ...

Risk of Stroke, Death, and Myocardial Infarction Following ...

Transcarotid artery revascularization was associated with a similar risk of 30-day stroke, death, or myocardial infarction or 1-year ipsilateral stroke in ...