Concierge vascular · United Kingdom
Endarterectomy — open plaque surgery, done properly, on time.
A named UK vascular surgeon, high-volume carotid unit, and the NICE 14-day window taken seriously. Carotid, femoral and iliac endarterectomy explained honestly — including when a stent or TCAR is a better option.
Why patients choose us
- 01
A consultant vascular surgeon, in a proper theatre
Not a generalist and not a training list. A named vascular surgeon in a unit that does carotid work every week.
- 02
The 14-day window taken seriously
For symptomatic carotid stenosis, benefit is greatest in the first 0–7 days after a TIA or minor stroke. We move fast.
- 03
Stent, TCAR or open — the honest comparison
CEA remains the reference. We tell you when a stent or TCAR is a genuine option, and when it is not.
Indicative pricing
What a private endarterectomy costs in the UK.
Indicative ranges across our UK partner units. Send the details and we quote firm figures across two or three options.
In short
A private carotid endarterectomy in our network: £12,000–£18,000, typically home on day 2.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Consultant vascular surgeon consultation | £250–£450 | 30–45 min | Same visit |
| Carotid duplex ultrasound | £300–£600 | 30 min | Same day |
| CT or MR angiography (neck) | £700–£1,400 | 30 min | 24–48 h |
| Carotid endarterectomy (CEA) — inpatient | £12,000–£18,000 | 90–120 min | 1–2 nights |
| Carotid artery stenting (CAS) | £10,000–£16,000 | 60–90 min | 1 night |
| TCAR (transcarotid revascularisation) | £14,000–£20,000 | 60–90 min | 1 night |
| Common femoral endarterectomy | £8,000–£14,000 | 60–90 min | 1–2 nights |
| Iliac endarterectomy (open) or hybrid | £12,000–£20,000 | 2–3 h | 2–3 nights |
Prices vary by unit, by consultant, by anaesthetic and by whether stenting or a hybrid procedure is added. We come back with a firm quote within one working day.
The problem
After a TIA, the clock is loud — most private pathways are quiet.
Symptomatic carotid disease benefits most from surgery in the first week. Yet imaging, review and theatre often drift. We compress the pathway.
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Symptomatic carotid stenosis
For 50–99% stenosis with recent TIA or minor stroke, CEA within 14 days — best in the first 7 — is the NICE standard.
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Asymptomatic disease, weighed
Not every 60–99% narrowing needs surgery. Fit, younger patients may benefit; many are better on medical therapy alone.
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Leg disease taken seriously
Common femoral endarterectomy is still the gold standard at the femoral bifurcation — often paired with iliac or SFA stenting.
The journey
From imaging to discharge — what happens, in order.
One coordinator, one consultant, one unit — from urgent duplex to the surveillance scan.
Phase 1 · Before surgery
Imaging and review, fast
Phase 2 · Admission
Day of surgery and overnight
Phase 3 · After
Follow-up and prevention
- 01
Before
You tell us what happened
A short, confidential form. TIA symptoms, stroke, or an incidental duplex finding — and when it happened.
- 02
Before
Urgent duplex and imaging
Carotid duplex plus CT or MR angiography to confirm the degree of stenosis by NASCET criteria. Booked within days, sooner if symptomatic.
- 03
Before
Vascular surgeon review
A named consultant reviews the imaging, the risk profile and the timing. Antiplatelet and statin started or optimised.
- 04
On the day
Admission and anaesthetic choice
General or local (cervical block) anaesthetic — the GALA trial showed both are equivalent. Your surgeon and anaesthetist explain which suits you.
- 05
On the day
The endarterectomy itself
A neck incision, the artery is clamped, plaque removed and closed with a vein or Dacron patch. Selective shunting if needed. Usually 90–120 minutes.
- 06
On the day
Recovery and overnight stay
Close neurological observation for the first few hours. Most patients go home on day 2.
- 07
After
Follow-up and lifelong prevention
Wound check at 2 weeks, duplex surveillance at 6 weeks. Lifelong antiplatelet, statin, blood-pressure control and DVLA notification as advised.
Symptomatic target: within 14 days of the event. Discharge: usually day 2.
When it helps
When endarterectomy is the right step.
The situations we see most, plus the one red flag that means A&E rather than an outpatient booking.
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Recent TIA (mini-stroke)
Transient weakness, speech disturbance or vision loss — with 50–99% carotid stenosis this is the strongest indication for CEA within 14 days.
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Minor ischaemic stroke, good recovery
A completed stroke with minimal residual deficit and tight carotid disease still benefits from early endarterectomy.
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Amaurosis fugax
A fleeting curtain of vision loss in one eye — a warning sign of carotid embolus and a formal indication for imaging.
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Asymptomatic 60–99% stenosis
Only for carefully selected younger, fitter patients where surgical risk is low — NICE and ESVS are cautious here.
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Critical limb ischaemia
Rest pain, ulcers or tissue loss with common femoral disease — endarterectomy remains the gold standard for the femoral bifurcation.
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Aortoiliac occlusive disease
Severe claudication or critical ischaemia from iliac plaque — endarterectomy, often as a hybrid with stenting, per TASC classification.
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Restenosis after previous surgery
A narrowing that returns years after a first endarterectomy — imaging, then a repeat CEA or a stent depending on anatomy.
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Red flag: active stroke symptoms
Ongoing weakness, slurred speech or facial droop is a 999 call for FAST assessment — not a clinic booking.
Procedure options
Open, endovascular or hybrid.
What each option actually involves — and which fits which patient.
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Carotid endarterectomy (CEA)
The reference operation. Open removal of plaque from the internal carotid, usually with a vein or Dacron patch closure.
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Carotid artery stenting (CAS)
Endovascular alternative. Data (ICSS, CREST) show it is inferior to CEA in symptomatic patients over 70 — reserved for specific anatomy.
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TCAR (transcarotid revascularisation)
A newer hybrid — a short neck cutdown with flow reversal during stenting. Lower stroke risk than transfemoral CAS in selected patients.
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Common femoral endarterectomy
The gold standard for common femoral disease — open plaque removal with patch closure, often at the femoral bifurcation.
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Iliac endarterectomy (open or hybrid)
Open endarterectomy of the iliac vessels, sometimes combined with stenting as a hybrid procedure per TASC classification.
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Local vs general anaesthetic
The GALA trial showed no difference in stroke, death or MI between GA and local (cervical block). Your surgeon will discuss which suits.
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Selective vs routine shunting
A temporary shunt keeps blood flowing during the clamp — some units shunt every case, others selectively based on stump pressure or awake testing.
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Patch angioplasty (vein or Dacron)
Closing the artery with a patch (vein or synthetic) rather than directly — reduces restenosis and is standard practice in UK units.
Our vetted UK network
A small panel of vascular surgeons, we picked them.
Consultant vascular surgeons in high-volume UK carotid units. Introductions are private, made once we understand your case.
Selection criteria
How we choose every surgeon in our network.
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Consultant vascular surgeons in high-volume UK carotid units
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Symptomatic patients booked within the NICE 14-day window
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Duplex, CTA and MRA available on-site or same-week
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TCAR available where genuinely appropriate — not as a default
Safety and recovery
What to expect — honestly.
Endarterectomy is a common, well-audited operation. The things worth planning are the anaesthetic choice, the perioperative risk, and the lifelong medical therapy that follows.
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Perioperative stroke or death (symptomatic)
Roughly 3–6% in NHS units for symptomatic patients — audited by the National Vascular Registry. Lower risk still means real risk.
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Perioperative stroke or death (asymptomatic)
Around 1–3% — which is why asymptomatic surgery is only justified in low-risk, fitter patients with long life expectancy.
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Cranial nerve injury (5–10%)
The hypoglossal, marginal mandibular and recurrent laryngeal nerves sit close to the operative field. Most injuries are transient.
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Myocardial infarction
Underlying coronary disease is common in carotid patients. Pre-op cardiac assessment and continued antiplatelet/statin therapy matter.
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Wound haematoma
A neck haematoma can compress the airway — rare, but the team is prepared to return to theatre if needed.
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Cerebral hyperperfusion syndrome
Headache, seizures or bleeding days after surgery from restored flow — uncommon, and why blood pressure is controlled tightly afterwards.
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Restenosis
A narrowing can return over years — patch angioplasty reduces this. Duplex surveillance picks it up early.
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Lifelong antiplatelet and statin
Aspirin or clopidogrel plus a high-intensity statin, blood-pressure control and no smoking — the operation treats the artery, not the disease.
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DVLA and driving
You must notify the DVLA after a TIA or stroke. Group 1 drivers usually stop for at least one month; Group 2 is longer. Your surgeon confirms.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the vascular surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication, side and degree of stenosis
Whether the operation was for symptomatic or asymptomatic disease, which carotid, and the NASCET-measured stenosis on the pre-op imaging.
- 02 Technique
Anaesthetic, shunt and patch used
General or local anaesthetic, whether a shunt was used, and whether the artery was closed with a vein or Dacron patch.
- 03 Findings
Plaque, cranial nerves and blood loss
Description of the plaque removed, comments on cranial nerve preservation, and any intraoperative issues.
- 04 Impression
Recovery, medication and surveillance
Read this first: expected recovery, antiplatelet and statin plan, DVLA advice, and when your surveillance duplex is booked.
Recognised by major UK insurers
Cover for endarterectomy is standard when medically indicated. We confirm authorisation with your insurer before booking.
Frequently asked
Everything we get asked about endarterectomy.
Quick answers on timing, stent vs surgery, anaesthetic choice, risks and recovery.
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What is an endarterectomy?
An endarterectomy is an open operation to remove atherosclerotic plaque from the lining of a diseased artery. In the neck it is called carotid endarterectomy (CEA); it is also done at the common femoral and iliac arteries in the leg.
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Why does a carotid endarterectomy need to happen so quickly?
For symptomatic carotid stenosis of 50–99%, benefit is greatest when surgery is done in the first 0–7 days after a TIA or minor stroke, and NICE recommends within 14 days. After that, the natural rate of a second, disabling stroke rises sharply.
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Is a carotid stent as good as endarterectomy?
For most symptomatic patients — particularly over 70 — the ICSS and CREST trials showed carotid stenting (CAS) carries a higher periprocedural stroke risk than open endarterectomy. Stenting still has a role in specific anatomy or high-risk necks. TCAR is a newer hybrid with flow reversal that improves those outcomes in selected patients.
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Should I have surgery if my carotid narrowing is not causing symptoms?
Only in carefully selected cases. Asymptomatic 60–99% stenosis can benefit from CEA if you are younger, fit, have a long life expectancy and are treated in a low-risk unit. Modern medical therapy is very effective, so NICE and ESVS are cautious about operating on asymptomatic disease.
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General or local anaesthetic — which is safer?
Neither. The GALA trial (2008) showed no significant difference in stroke, death or heart attack between general anaesthetic and local (cervical block) for CEA. It is a preference and unit-based choice.
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How long is the hospital stay and recovery?
Most patients stay one to two nights and go home on day 2. The wound settles over two weeks. You will need blood-pressure monitoring at home, and driving is restricted after a TIA or stroke — the DVLA must be notified.
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What are the main risks?
The most important is a perioperative stroke or death — around 3–6% for symptomatic patients and 1–3% for asymptomatic disease in a good unit. Cranial nerve injury is 5–10% and usually transient. Other risks include neck haematoma, MI, hyperperfusion syndrome and long-term restenosis.
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What about endarterectomy in the leg?
Common femoral endarterectomy remains the gold standard for disease at the femoral bifurcation, often combined with iliac or superficial femoral stenting as a hybrid procedure. Iliac endarterectomy is used selectively for the aortoiliac segment per TASC classification.
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