Posted By margot on June 16, 1999 at 12:31:41
My father-in-law has a 100% occluded carotid artery. He is 77 and in otherwise good health, although has had several "episodes" (light-headed, and some brief aphasia) one of which was probably a small stroke. He has been told that since the blockage is 100% it is standard procedure to NOT do the surgery. Should he get a second opinion?
Posted By CCF CARDIO MD - CRC on June 16, 1999 at 16:25:09
Thank you for your question. You are correct that surgery is not recommended for 100% occluded arteries. The rational is that it is already closed and the area it used to supply has new blood flow from elsewhere.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
This may seem to be a very stupid question but after having seen so many inquiries from people with 100% occlusions and 95% occlusions, I wonder why the doctors don't let people just go on to the 100% without doing surgey. I underwent an endartarectomy which put in a gortex graft from aorta to carotid bifurcation. Within a month or so it was completely occluded. There is retrograde flow from the external into the internal. Who knows where the external flow is coming from.
I am glad I had the surgery because a lot of other things that the docs didn't think had to do with the carotids did clear up but I wonder why surgery is recommended when the natural progression is to 100% and the docs say that is fine.
Posted By CCF CARDIO MD - CRC on June 17, 1999 at 09:44:28
The problem is you don't know which people have the collateral circulation. If that is not present and the blockage proceeds to 100% the results can be a stroke at the best and fatal at the worst.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician
can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire
online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Thanks for your answer.
My uncle recently had a stroke but is doing fairly well. He is on Heparin and Coumadin after a week in the hospital. He had carotid surgery last year and apparently had stents put in. There are occlusions above and below. His tongue was partially paralyzed (root to tip) due to the techniques used during the endartarectomy. Now they are waiting for his regular doctor to come back from vacation due to some sort of research that is going on at CCF to see if he can be enrolled. Do you know anything about this program? Can you relate anything about it?
Posted By CCF CARDIO MD - CRC on June 18, 1999 at 08:04:31
There are numberous research projects underway here and I'm not sure which one your uncle is being considering. Do you know is it a drug trial or a surgical trial?
Posted By Doris on June 18, 1999 at 11:11:11
I have an elderly friend (80) who had carotid artery blockage. One year ago they tried to do surgery but had to stop due to some complication. Another surgery was sucessful two months ago but ever since he has had a slight cough, says he feels as if something is "tickling" his throat, and shortness of breath constantly. All xrays and tests are normal according to his doc. Do you have any idea what could be causing this SOB and coughing sensation? Thanks for any info you may give to shed some light on this very annoying and distressing condition.
I gather the research project is surgical. (I'm getting all my info 4th hand.) Apparently they were aware when they did the original endartarectomy that there was considerable occlusion both north and south of the site that they worked on. That site is in pretty good shape but the areas north and south are more clogged than before. I also gather that the reason he suffered nerve damage to his tongue (affecting speaking and swallowing) was that they were trying to get to these areas but for anatomical reasons, could not.
This is of interest to me, also, because the greatest constriction to my carotid was very low in the neck. My surgeon (we live in a different area than my uncle) opted to put in the bypass by way of open chest surgery.
Would the fact that my uncle has had coronary bypass surgery in the past would not permit a regular carotid bypass?
On a different subject, when I die, I want to have my body donated to CCF for research/learning purposes in vascular disease. Do you know how to go about that? I got the major shuffle when I asked about donating my larynx (that's about the only part of my body that isn't diseased) but I figure vascular disease is more established so maybe you would know.
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