Abstract
Treatment of severe carotid artery stenosis to prevent stroke is arguably the most significant and perhaps the best vascular reconstructive operation in the speciality as a whole. It is nothing short of an icon for evidence-based medicine, but it is not without challenges. An estimated 20% of carotid endarterectomy (CEA) procedures are done on so-called 'high-risk' patients, mostly related to unfavourable vascular or neck anatomy. Medical co-morbidities - cardiac mainly - can also increase risk or even preclude performance of CEA, although only infrequently.
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