Risk of placing stent in carotid artery.

Two years ago, we found my husband's right carotid was 100% blocked and probably had been "for some time". At the same time, the left carotid had a less than 75% blockage. The cardiologist said the right could not be bypassed or repaired in any way, and he said that repairing or bypassing the left side was not a good idea. He explained to us that, with the right 100% blocked, there was too much risk involved in attempting to repair or bypass the left because, should the repair fail, his risk of stroke and/or death would be too high. Now, a different cardiologist has him scheduled for an angiogram next week, with the possiblity of inserting a stent on the lift side. When we mentioned the first doctor's concern, the current doctor said there was no cause for concern because "there are actually four carotids and two can do the job". At this point, we are very confused. One recommended doing nothing two years ago, and the second acts as if it's no big deal. (I am adding that the current physician was not familiar enough with my husband's chart to even realize the blockage had been found two years ago.)


This discussion is related to Urgent : Left Carotid Subclavian Bypass v/s Stent in Subclavian.

[ed34]

Firstly I only know of one Carotid artery on each side of the neck, not two. I would question why he said this. I think basically what has turned events is the fact that the
blockage on the left side has been seen as too much of a risk to leave alone. With no
blood supplied from the right, if the left blocks then death is imminent. I have found through experience that a Cardiologist will not say he can do something if he cannot.
He hasn't really committed himself yet, he is being cautious by saying he will perform an
investigation Angiogram first. If he feels he cannot continue due to the risks, he will stop.
Another thing you could ask your Cardiologist about is a procedure known as an endarterectomy to the vessel which was once very common. The inner layer is removed
with the disease, leaving it clean. However, this leaves a rough surface encourageing
restenosis but medication should handle that. If treatment is successfully administered
to the left side, then that means they should be able to do something to the right side
with less risk.