62-year-old man for consideration of Right carotid Endarterectomy vs Stent

Background

• Left CEA 2001
• Adult polycystic kidney disease – Haemodialysis dependent
• Hypertension
• NIDDM – Diet only
• Recent normal sestamibi

Issues

• Asymptomatic high-grade right internal carotid artery stenosis – 80%
• Previous TIA and left CEA
• On clopidogrel

Discussion

CEA vs Stent

• Patient suitable for either procedure as per surgical decision
• Minimal anaesthetic required for carotid stent
• Stent often performed by interventional neuroradiologist

Plan

• Inform surgical team of meeting outcome
• Proceed with either procedure