Published on July 07, 2022

Innovative Procedure to Treat Carotid Artery Disease Now Offered Locally

Photo of Dr. Balogun, Dr. Frisbie and Dr. Constantinou.

The TCAR procedure is being performed by Vascular Surgeons (left to right) Yetunde Balogun; M.D., M.P.H.; Jacob Frisbie, D.O.; and Constantinos Constantinou, M.D..

An innovative new procedure to treat carotid artery disease and prevent future strokes is now being performed at MyMichigan Medical Center Midland. This procedure, TransCarotid Artery Revascularization or TCAR (tee-kahr), is a minimally-invasive, clinically proven approach for high surgical risk patients who need carotid artery treatment.

According to the Centers for Disease Control and Prevention, every 40 seconds, someone in the United States has a stroke.1 Worldwide, nearly five million people die from a stroke, and another five million are left permanently disabled every year.2 Carotid artery disease is a form of atherosclerosis, or a build-up of plaque, in the two main arteries in the neck that supply oxygen-rich blood to the brain. If left untreated, carotid artery disease can often lead to stroke. With up to a third of strokes caused by carotid artery disease3, MyMichigan Health offers patients minimally invasive options such as TCAR to prevent future strokes.

“This minimally-invasive procedure is an important option in the fight against stroke and is particularly suited for the large portion of patients we see who are at higher risk of complications from carotid surgery due to age, anatomy, or other medical conditions,” said Vascular Surgeon Constantinos Constantinou, M.D. “Because of its low stroke risk and faster patient recovery, I believe TCAR represents the future of carotid repair.”

The TCAR procedure is unique in that blood flow is temporarily reversed during the procedure so that any small bits of plaque that may break off are diverted away from the brain, preventing a stroke from happening. A stent is then placed inside the artery to stabilize the plaque, minimizing the risk of a future stroke.

Prior to TCAR, the main treatment option for severe carotid artery disease was an open surgical procedure called carotid endarterectomy (CEA). CEA removes plaque from inside the carotid artery to restore normal blood flow to the brain, but the large incision leaves a visible scar the length of the neck and carries risks of surgical complications, including bleeding, infection, heart attack and cranial nerve injuries that can cause issues with swallowing, speaking and sensation in the face. 

The TCAR procedure was developed by Sunnyvale, California-based Silk Road Medical, Inc. and includes the ENROUTE® Transcarotid Neuroprotection (N.P.S.) and Stent System – the first devices designed and FDA-approved specifically for TCAR. Over 35,000 TCAR procedures have been performed worldwide through clinical trial and commercial use. TCAR has been studied extensively, and the clinical data have been excellent. Those interested in more information about the TCAR procedure may visit

The TCAR procedure is being performed by Vascular Surgeons Yetunde Balogun,

M.D., M.P.H.; Jacob Frisbie, D.O.; and Constantinos Constantinou, M.D. Those who would like more information about these surgeons or MyMichigan’s comprehensive Heart and Vascular Program may visit