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Stroke Prevention Surgery - Carotid Endarterectomy - clearing the carotid before the next stroke.

Removing plaque from the internal carotid artery within days of a TIA or minor stroke - the operation that prevents the big one.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What stroke prevention surgery - carotid endarterectomy costs privately in the UK.

Indicative ranges across our partner units.

In short

£9,500–£15,500, home the day after.

Service Indicative range
Carotid endarterectomy (day-case pathway) £9,500–£15,500
Carotid endarterectomy with HDU stay £12,000–£19,000
Carotid artery stenting (CAS) £11,000–£17,500
Urgent carotid Doppler £280–£450
CT angiogram head and neck £450–£850
Vascular surgeon consultation £280–£450

Carotid surgery for symptomatic stenosis is almost always covered.

The problem

The 14-day window is where lives are saved.

Carotid surgery works best when it happens fast. In the NHS, that window is often missed by paperwork. We keep it open.

  • Every day of delay costs benefit

    The absolute risk reduction from CEA halves each week beyond day 14. Speed is the treatment.

  • Not every stenosis is a surgical stenosis

    Under 50 percent doesn’t benefit. Over 70 percent, symptomatic, usually does. The 50–69 range is where MDT judgement earns its keep.

  • BP and statin are half the operation

    Perfect surgery with sloppy prevention still gives you the second stroke. Both, together.

When it helps

The situations where this is the right step.

The situations we see most, plus the red flag that means urgent care rather than a routine appointment.

  • Recent TIA with carotid stenosis

    A resolved deficit in the last 6 months with 50–99 percent symptomatic stenosis is the classic indication. Sooner is better.

  • Recent minor stroke with good recovery

    A completed stroke with mRS 0–2 and symptomatic 50–99 percent stenosis - surgery within 2 weeks reduces recurrence.

  • Amaurosis fugax

    A curtain of vision loss in one eye is a retinal TIA - carotid imaging within days, surgery within 2 weeks where indicated.

  • Asymptomatic tight stenosis 70–99 percent

    Selected cases after MDT, weighing the low annual stroke risk against the perioperative risk. Not automatic.

  • Contralateral occlusion with tight stenosis

    One-sided cerebral perfusion makes the operation higher-stakes but often more valuable. MDT decides.

  • Recurrent stroke despite antiplatelet

    Stroke on best medical therapy is the strongest indication - urgent surgical review.

  • Fresh crescendo TIAs

    Multiple resolving deficits in a week is a warning: urgent duplex and surgery within days, not weeks.

  • Red flag: fluctuating deficit and tight stenosis

    A worsening deficit with 90 percent stenosis is a stroke-in-evolution - 999 and same-week theatre.

Options

Approach and extent depend on the case.

What each option involves - and where each earns its place.

  • Carotid endarterectomy (CEA) - standard

    The workhorse - open plaque removal with patch closure. Best evidence, lowest recurrence, cranial-nerve care from an experienced vascular team.

  • CEA under cervical block

    Awake surgery lets the team monitor speech and movement continuously. Useful where shunt use should be selective.

  • CEA with intraoperative shunt

    A temporary plastic tube carrying blood across the clamped segment. Standard where TCD or awake assessment flags falling perfusion.

  • CEA with eversion technique

    The internal carotid is transected and turned inside out to remove plaque - no patch needed. Selected anatomies only.

  • Carotid artery stenting (CAS)

    Endovascular alternative through the femoral or radial artery. Preferred in some restenoses, hostile necks or higher medical risk.

  • Transcarotid artery revascularisation (TCAR)

    Direct carotid access with flow reversal - a hybrid stent option in selected higher-risk patients.

  • Best medical therapy alone

    Aspirin, statin, BP control, smoking cessation, glycaemic control. Sometimes the right answer, especially in low-risk asymptomatic disease.

  • Combined CEA and cardiac surgery

    Rare - reserved for tight bilateral disease with critical coronary disease. Sequenced or staged, MDT-led.

Our vetted UK network

A small, hand-picked panel of clinicians.

Consultants across London and the major UK cities. Introductions are private once we understand your case.

  • Consultant vascular surgeons with published carotid volumes

  • Vascular MDT with stroke physician and neuroradiologist

  • HDU-level post-op BP monitoring, and neuro-observations

Safety and recovery

What to expect - honestly.

The things worth planning for, and the red flags that mean same-day care.

  • Perioperative stroke or death

    Under 3 percent for symptomatic disease in experienced hands; under 3 percent for asymptomatic, per NICE.

  • Cranial-nerve injury

    Hypoglossal, vagus, marginal mandibular - usually temporary, under 5 percent long-term. Warned and consented.

  • Wound haematoma

    A tight neck haematoma is the emergency - airway threatened. Return to theatre is uncommon but planned for.

  • Myocardial infarction

    These are vascular patients - a small perioperative MI risk sits behind the numbers. Cardiac optimisation before surgery is standard.

  • Hyperperfusion syndrome

    A rare but serious cause of headache, seizure or intracranial haemorrhage after CEA - tight BP control prevents it.

  • Restenosis

    Under 5 percent at 5 years with patch closure. Duplex surveillance picks it up early.

  • BP control is the operation, too

    Below 140/90 before and after. Home BP monitoring at 6 weeks. Statin at high-intensity dose.

  • Driving and DVLA

    One month off driving Group 1 after a TIA or stroke - the operation does not reset that clock on its own.

  • Red flags after surgery

    Fresh neurological deficit, expanding neck swelling, severe headache with vomiting or bleeding through the wound is 999, not a routine call.

Reading your notes

Your report in four parts. Read the last one first.

Whatever the pathway, the summary keeps to the same shape.

  1. 01 Indication

    Symptomatic vs asymptomatic

    Which side, which symptom, when it happened, and the degree of stenosis measured by NASCET criteria on angiography.

  2. 02 Operation

    Approach, patch, shunt

    Anaesthetic (GA or cervical block), whether a shunt was used, patch material, and clamp time.

  3. 03 Findings

    Plaque, distal disease, closure

    What the plaque looked like, whether tandem intracranial disease was seen, and the completion imaging or handheld Doppler.

  4. 04 Plan

    Prevention and surveillance

    Read this first: aspirin, statin, BP target, duplex at 6 weeks then annually, and the contralateral artery plan.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Frequently asked

Everything we get asked about stroke prevention surgery - carotid endarterectomy.

  • How urgent is carotid surgery after a TIA?

    Very. NICE says surgery within 14 days of the event carries the greatest benefit.

  • Do I need surgery for asymptomatic carotid stenosis?

    Not always. The annual stroke risk on best modern medical therapy is under 1 percent for many. Surgery is offered for selected 70–99 percent asymptomatic stenosis where life expectancy is at least 5 years and MDT judges the benefit worth the operative risk.

  • Is stenting an alternative to open surgery?

    Yes, in selected patients - those with hostile neck anatomy, restenosis after CEA, or higher medical risk. Open CEA remains the gold standard for most, especially symptomatic patients over 70.

  • What are the risks?

    Under 3 percent perioperative stroke or death in experienced hands. Cranial-nerve injury under 5 percent long-term, usually temporary. Wound haematoma, MI, and hyperperfusion syndrome are rare but planned-for complications.

  • How much does private carotid endarterectomy cost in the UK?

    Roughly £9,500–£15,500 for a day-case pathway and £12,000–£19,000 with an HDU stay. Carotid stenting is £11,000–£17,500. Rapid diagnostics run £280–£850.

  • When can I drive after CEA?

    One month off Group 1 driving after the TIA or stroke itself; the operation does not extend that clock, but you should not drive until wound comfort allows an emergency stop and neck rotation - usually 1–2 weeks post-op.

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