Abstract
Retropharyngeal carotid artery occlusive disease presents a formidable challenge for surgeons due to its anatomic location and increased potential for complications. Conventional treatments, including open revascularization and transfemoral stenting, often face limitations. Transcarotid artery revascularization (TCAR) has offered a promising alternative, integrating a hybrid surgical and endovascular approach. We present a case of an elderly patient with severe symptomatic stenosis of a retropharyngeal carotid artery treated with TCAR. We review the potential injuries reported with the use of transfemoral stenting and endarterectomy in this setting and suggest that TCAR may be a safer modality for its treatment.