 My name is Mohammad Nasir Khan. I'm a vascular surgeon and I practice at Jersey Shore University Medical Center of Hackensack Meridian Health. My practice involves vascular surgery and endovascular surgery. TCR is an abbreviation that stands for transcarotid artery revascularization. It is one of the newer methods of treating carotid artery disease to either treat patients who had symptoms of stroke or asymptomatic patients. Patients who have had a recent heart attack, patients who have congestive heart failure and when we talk about anatomic high risks these are patients who for example have had a carotid endotrectomy before but now they have developed recurrent narrowing in their blood vessel. So these are the patients who are excellent candidates for TCR surgery. We make a small incision just above the collar bone and once that blood vessel is dissected out we get control of it then we also get access into the patient's big vein in the groin either the right or the left side. Then using the end route TCR approved system we can reverse the blood flow in the carotid artery. So the blood instead of flowing towards the brain now is flowing towards the groin of the patient. That way when we do the stenting in the carotid artery any debris that would have otherwise gone to the brain and could have caused a stroke is prevented. The benefits of TCR are it is less invasive. In my opinion it takes the best of both worlds. It combines a component of open surgery and a component of endobascular surgery in a hybrid fashion. My patients stay in the hospital overnight for monitoring of their neurological status and clinical status. Generally I tell my patients recovery is instant because they are allowed to do all everyday activities right away. As of now we have done a significant number of TCR procedures. All have been very successful without any complications whatsoever and I believe that makes us leaders in providing the best possible carotid artery disease care including carotid endocrinectomy and TCR to our patient population and that also makes us at Jersey Shore Hospital at the forefront of providing cutting-edge medical care to our patients.