Do I need general anesthesia for TCAR?

Usually not. TCAR is typically performed under local anesthesia with light sedation, which puts less stress on the heart. That's one reason it's a good option for higher-risk patients.

How long does TCAR take, and what's recovery like?

The procedure usually takes 60 to 90 minutes, with a short hospital stay of one to two days. Most people return to their normal activities within about a week.

How is TCAR different from a carotid endarterectomy?

A carotid endarterectomy is open surgery that removes plaque through a larger incision in the neck. TCAR uses a much smaller incision plus a brain-protection system, so there's less tissue trauma, less nerve-injury risk, and a faster recovery.

Am I a candidate for TCAR?

TCAR is especially valuable for people with significant carotid narrowing who are considered higher-risk for open surgery. A full evaluation confirms whether it's right for you. That includes your history, an exam, and imaging like carotid ultrasound or CT/MR angiography.

What are the risks of TCAR?

Any carotid procedure carries some risk, including stroke, bleeding, nerve injury, and re-narrowing over time. TCAR targets the biggest of these: its flow-reversal system protects the brain during treatment, and the small incision carries less nerve-injury risk than open surgery. Your surgeon will walk through your personal risks before anything is decided.

Is TCAR covered by insurance?

In most cases, yes, including Medicare. We accept most insurance plans and verify your benefits before anything is scheduled.

TCAR, stroke prevention with less risk

When plaque builds up in the carotid arteries, it can increase stroke risk. TransCarotid Artery Revascularization (TCAR) is a minimally invasive procedure that treats carotid disease while protecting your brain the entire time. Empire Vein is the #1 provider of TCAR in California.

Procedure time

60–90 min

About half the time of open surgery

Recovery

~1 week

Back to normal activities

Safety

Protected

Blood flow reversed away from the brain

What is TCAR?

Carotid artery stenosis is a narrowing of the arteries that carry blood to your brain. TransCarotid Artery Revascularization (TCAR) is a minimally invasive procedure that treats it while minimizing the risk of stroke during treatment itself.

Traditional options include carotid endarterectomy (open neck surgery) and stenting through the groin. Both work, but they carry a risk of dislodging plaque that can travel to the brain. TCAR takes a smarter path: a small incision at the base of the neck, plus a system that temporarily reverses blood flow to protect the brain. It's a leading treatment for carotid artery disease.

It protects the brain

If any plaque breaks loose during treatment, it's carried into an external filter instead of toward the brain.

A small neck incision

TCAR reaches the carotid directly through a tiny incision, with no long path up from the groin.

Built for higher-risk patients

It's a safer option for people who aren't ideal candidates for open neck surgery.

Dr. Son Ha Yu

Board-Certified • Fellowship-Trained Vascular Surgeon

What our doctors think of TCAR

“What makes TCAR different is that we're protecting the brain the entire time, reversing blood flow so any debris can't cause a stroke. For patients who are higher-risk for open surgery, it's one of the safest ways to treat a dangerous carotid narrowing.”

How it works

TCAR combines the best of surgery and minimally invasive technique, with the brain protected the whole time.

Access at the neck

You're kept comfortable with local anesthesia and light sedation instead of general anesthesia. Your surgeon makes a small incision at the base of the neck to reach the carotid artery.

Blood flow is reversed

A flow-reversal system gently redirects blood away from the brain and through an external filter. Any plaque debris loosened during the procedure is caught before it can reach the brain.

A stent is placed

Through the same small opening, your surgeon widens the narrowed artery and places a small stent to hold it open, restoring healthy blood flow to the brain.

Recovery begins

Normal blood flow resumes and the incision is closed. The whole procedure takes 60–90 minutes, and most patients go home within a day or two.

Who's a candidate?

TCAR is especially valuable for people with significant carotid narrowing who are higher-risk for traditional open surgery.

TCAR may be right for you if you have

Significant narrowing of the carotid artery

Narrowing that has come back after a previous procedure

A carotid blockage that's difficult to reach

A preference for a less invasive option and faster recovery

It's often chosen for higher-risk patients, including those with

Advanced age (75 and older)

Previous neck surgery or radiation

Anatomy that makes open surgery difficult

Heart, lung, or kidney conditions

Every candidate gets a full evaluation before we recommend TCAR: medical history, a physical exam, and imaging like carotid ultrasound, CT, or MR angiography.

Why patients choose it

For the right patient, TCAR offers real advantages over both open carotid surgery and traditional stenting.

Lower stroke risk during treatment

The flow-reversal system significantly lowers the risk of a procedure-related stroke versus traditional stenting.

Minimally invasive

A small neck incision means less tissue trauma, less nerve-injury risk, and minimal scarring.

Faster recovery

Most patients are back to normal activities within about a week, not several.

A shorter procedure

TCAR typically takes less than half the time of a carotid endarterectomy.

Proven results

Studied in the ROADSTER trials, with high technical success and low stroke rates.

Easier on the heart

Local anesthesia and a shorter procedure put less strain on the heart than open surgery.

Why choose Empire Vein

The #1 provider of TCAR in California

Our fellowship-trained vascular specialists have performed more TCAR procedures than any other practice in the state. They build a customized plan around each patient, with clear communication every step of the way.

500+

carotid procedures performed by our surgeons

Top 5

most experienced TCAR teams in the country

20+ years

serving Southern California

4.8★

from 2,000+ verified patient reviews

TCAR, answered

The questions patients ask us most about the procedure.

For stroke risk during treatment, yes. TCAR's flow-reversal system protects the brain while the artery is being treated, which significantly lowers the risk of a procedure-related stroke compared to traditional carotid stenting.

Insurance

When your veins cause symptoms like aching, swelling, or skin changes, treatment is typically considered medically necessary, including under Medicare. We'll help you verify your benefits.

Most major plans accepted