CAROTID ENDARTERECTOMY (CEA)
Indication: Symptomatic internal carotid artery stenosis ≥50–70% (transient ischaemic attack or stroke in the preceding 6 months). Asymptomatic stenosis ≥60–80% in selected good-risk patients. Reduces the risk of stroke by approximately two-thirds in symptomatic patients with significant stenosis. Morbidity and mortality <2% in experienced hands.
Patient Position: Supine, head on ring, slightly extended and turned away from the operative side.
Anaesthesia: General or regional (cervical block). Intra-operative monitoring: neurological assessment (awake patient with cervical block allows direct assessment), EEG, transcranial Doppler, or stump pressure measurement used to determine need for shunt.
Prophylactic Antibiotics: Per protocol.