Impact on practice: an independent audit of carotid endarterectomies performed over a 15-year period by a single surgeon

This audit demonstrates an outcome consistent with currently accepted standards. It led to a modification of practice resulting in a trend towards favouring vein patches, less shunting and a reduced incidence of transient cranial nerve palsy. As demonstrated here, it is imperative that all surgeons quote their own results rather than those of the international trials to justify clinical practice. Continued audit is essential to ensure quality of practice.