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!!