Posted on October 20, 2020

PCI Vascular Surgeons Earn Prestigious Honor

David Lawrence, MD, FACS, and Jared Kray, DO, FACS, vascular and endovascular surgeons at Physicians’ Clinic of Iowa, Cedar Rapids, were both named 2020 TCAR Clinical Operators of Experience for improving carotid artery disease treatment using an innovative procedure called TransCarotid Artery Revascularization (TCAR). TCAR (tee-kahr) is a clinically proven, minimally invasive and safe approach for high surgical risk patients to reduce their risk of stroke.

Carotid artery disease is a form of atherosclerosis, or a buildup 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. Carotid artery disease is estimated to be the source of stroke in up to a third of cases, with more than 427,000 new diagnoses of the disease made every year in the U.S. alone.

TCAR developer, Silk Road Medical, reviewed physicians across the country to recognize the physicians that have embraced the TCAR procedure. TCAR Clinical Operators of Experience have demonstrated a focus on patient outcomes through appropriate patient selection and a well-trained and credentialed vascular specialist team. This recognition demonstrates both Dr. Lawrence and Dr. Kray’s commitment to delivering the highest quality of care to their community.

“TCAR is an important new 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 Dr. Lawrence. “We are very excited to have been recognized for our efforts to modernize carotid artery repair.”

TCAR is unique in that blood flow is temporarily reversed during the procedure so that any small bits of plaque that may break off during the procedure 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. Patients recover quickly and almost always go home the next day to return to full and productive lives with less pain and small scars.

Prior to the development of 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. 

About TCAR

The TCAR procedure was developed by Sunnyvale, California-based Silk Road Medical, Inc. and includes the ENROUTE® Transcarotid Neuroprotection (NPS) and Stent System – the first devices designed and FDA-approved specifically for TCAR. Over 20,000 TCAR procedures have been performed worldwide through clinical trial and commercial use. TCAR has been studied extensively, and the clinical data have been excellent. Additional information about TCAR is available at

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