Carotid Endarterectomy

1. History and Examination

2. Non Invasive Vascular lab - recent duplex of carotids, repeat duplex if greater than 4 weeks. 99%-100% stenosis will require MR angiogram of carotids to exclude total occlusion Document results in chart

3. ECG and CXR

4. CT Brain. Ischaemic risks, haemorrhage infarct or neoplasm

5. Bloods FBC, U&E, coag screen, G&H. Fasting risks.

6. ECHO and Holter

7. ENT consult - vocal cord assessment preop. +/- Cardiology and Respiratory. consult.

8. Informed consent, including explanation to family. Explain risk of CVA (2-5 % risk of stroke post carotid endarterectomy), also risk of vocal cord injury, see 11.1.4.

9. Check the side document it on the chart and consent farm. Mark and initial the side, see 14.3