100% blockage of left carotid artery

[adisim]

My Dad is 68 years old and had 3 TIAs last year (a week apart) with 100% recovery after all of them. The angiogram showed 100% blockage of left carotid artery. The right artery and the two on the back  are enlarged and the doctor thinks will never get clogged. He gets colateral blood supply through these 3 arteries and even from the left artery(in an unusual way going from the eye to the brain). He never had any health problems before, he doesn't smoke, doesn't drink, doesn't have high blood presure, doesn't have heart problems and follows a healthy diet. He is on coumadin, aspirin and lipitor treatment (his colesterol was 207 but dropped to 140) and seems to be doing well. Is this treatment the best for his situation? Is there anything else I can do to make sure he will be O.K.? Does he needs an angiogram every year? Why the 3 TIAs happened since he has colateral blood flow? What are the chances to happen again? Thank you so much! Simona.

[EXERNUT]

Hi Simona---First let me say that I am not a doctor, but I did have 100% blockage in one of my vertebral arteries.  What the doctor's told me was that the carotid was usually the first to get clogged (from cholesterol buildup), but mine was a little odd--as I had just turned 35 and it started in my vertebral.  I was prescribed the same treatment as your father.  

The reason the blockage is bad--even if he is getting colateral blood supply-the blood that is pumping from his heart to go up that blocked artery hits a wall because of that 100% blockage & then goes right back to the heart in the wrong direction before your heart is ready for it--over time this will cause damage to the heart. The hope is to try to get the blockage to at least open--even if it is just a small trickle--so that the blood is at least flowing in the correct direction--even if the other 3 arteries are doing the real work. My blocked artery has done just that without surgery, so it is possible.  

Any blockage can cause a TIA and 100% blockage is going to increase the liklihood of that happening.  I would hope that the blood thinners will help with the blood flow in that artery so that surgery will not be required---but you have to give it time to work. With a blockage, you are always at risk for a TIA or stroke, which is why it is very important to be rechecked every year.

I hope this helps a little without scaring you too much. There is only so much you can control--you eat right, exercise, take your meds and don't smoke, but sometimes it just doesn't matter--things happen anyway. For me, I just do my part & trust that the doctors know what they are doing--if something doesn't sound right I speak up and ask questions, but in the end they are usually right. For you, I would suggest that you try to stay positive & supportive because that is what he needs to hear from you.  It is important for him to believe in his doctors, which means that you need to believe in his doctors as well.  I wish you both the best of luck!!

[chapo]

Hi Simona,  my father also has a occluded or 100% blockage left internal carotid artery. he also has a blocked left subclavian and 50-70% blocked right carotid.  he was left with a disabling stroke but has survived.  I have done a lot of reading on this and surgery to re-open the artery has been discontinued as the rate of complication/death hit 42 percent. Your father was lucky to have avoided a stroke from this so his collateral circulation must be good. Keeping his risk factors under control as you are is the only option so good luck

[adisim]

Hi Exernut, thank you so much for your reply, I appreciate any info I can get, I am sorry to hear you had to go through something similar at such a young age. You said your artery reopened? It's that true? Because of the blood thiners? I was told it's not possible, maybe your blockage was caused by a blood clot and not by cholesterol buildup? Did you have a angiogram to confirm 100% blockage? Sorry for so many questions. Thanks again for your time and for everything.

[adisim]

HI Chapo, thank you so much for sharing with me your Dad experience. Sorry that he was left with some diability, but the most important think it's that he survived and he has you to care about him and help him. Good luck to you as well.

[EXERNUT]

I had a CAT scan & my vascular surgeon showed it to me & said that it was bad.  The artery literally looked like a twig that was all shredded & dried up.  They didn't do the angiogram because the complete blockage was so obvious that it wasn't necessary for a diagnosis.  He also confirmed that it was cholesterol from the shape of the blockage--cholesterol looks different than a clot.  He also told me that it would not open up--ever--I guess cholesterol just doesn't break down.  I don't know if it actually has opened any at all, but the blood is not reversing to my heart like it was a year ago, so at least some has to be getting through.  I think that maybe my age is the reason...perhaps the blockage was relatively new, so when I started taking the cholesterol medicine with the blood thinners it was enough for me--for now.  I didn't mean to mislead you before--my artery hasn't opened up, it just appears to not be 100% blocked any more.  The doctors told me that I was lucky, but I still have to have it monitored every year & surgery may be down the road for me. As far as your father, considering his age & history, he will probably not have the same luck.  Surgery is probably the most likely option in his future, but it may not be right now. His doctors have to at least try the medicine & any other possible options first, because they just might work.  My doctor told me that surgery is always a last resort--and only if it is  absolutely necessary. So just try to be supportive & know that some things are beyond our control.

Best of Luck!!
      

[adisim]

Thank you so much EXERNUT for taking the time and answer to my questions.I wish you all the best and good luck.Thanks again. Simona.

[laaz]

my dad had his left cartoid artery blocked 70-80 %- the right was about 40-50% blocked. He was 81 at the time. His vascular doctor told him he needed surgery and if he didn't, he would probably have a 30% chance of having a stroke within the yr. Doctor also said less than 1% chance of having a stroke on the table from the surgery, so my dad had the surgery and had a severe stroke on the table. Can't talk, walk, has a cathater for urine, is on pureed food and thickened liquids.  I wish to god that he never had the surgery as he was driving, going out every day and now all he does is go from the bed to his wheelchair.  I quit my job as a nurse to care for him in my home now.  It has been 2 yrs. now and he is slowly going.  he has which i believe are TIA's now, which i hope one will just take him in his sleep and put him out of this nightmare.  Most doctors think they are God, Why would a doctor do such a risky surgery on an 81 yr. old man.  Always think before any surgeries.

[laaz]

I posted a comment and forgot to direct this message to you. See yesterdays comment from laaz