carotid artery blockages

After an angiogram, my brother has been diagnosed with l00% blockage of the right external carotid artery, 50%stenosis right internal carotid artery origin short segment nonulcerated and an occlusion of the left common carotid artery. He is 51, but at age 18 he had radiation for a tumor in his nasopharynx.  He has had serial dilations of his throat resulting in a trach & stomach tube 10 yrs. ago.  The radiation has been suggested as a reason for his premature hardening of his carotid arteries.  Is it advisable for him to have intervention on this arteries given his history?  He has recently been diagnosed with hypotension after passing out several times upon rising from a sitting position.  He is on plavix, aspirin,lipitor,amitriphyline, and had been taking altace until the last episode.

[CCF-M.D.-MJM]

Hi z.

Sorry to hear about your brothers condition.  Radiation vascular disease can present this way.  We tend to see a lot of coronary disease in Hodgkin's patients for example.

The best advice I can give to let an experienced reviewer look at these films and decide the feasablity of doing an intervention.  This is not a slam dunk easy case.  Dr. Jay Yadav here at the Cleveland Clinic is very good with carotid stents.  If you are in this area, it may be worth hearing his opinion.  You may even be able to send him your informatin for an e-consult over email.

It is possible that hypoperfusion is responsible for his passing out.  There are also pressure receptors in his neck that may be compromised from the radiation and leading to these passing out episodes.

I hope this helps and thanks for posting.

[Karonnie]

Hey maybe you could look at my post under Tetracyclines and Calcification especially in my post to maryroe later on.

There has been some amazing results with this antibiotic family and i'm living proof.

If you are looking for alternatives to surgery this is definately something you could consider to discuss with your brother.

I wish him well he sounds like he's had some really tough times!

[lisapep]

Ok here is a wierd one.  This morning i felt my heart or what i thouht was my heart palpitate.  when i put my hand on my pulse it was steady.. did not feel like it was fluttering at all.  however i felt it in my chest.  Can anyone offer any insight.  Could it be a spasm, air bubble? I have done a 24 hr holter and it shows bening sinus tach. aside from that all was fine.  any insight woul dbe fine

[nymomof5]

My heart palpatates with pvc's quite often and I feel it all in my chest and not really my pulse.  The only thing I feel in my pulse is the gap between the heartbeats.  I feel the "thumps" of the pvc in my chest only.