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Dear Doctors, My Father Suffered A TIA 7 Days Ago

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Posted on Thu, 23 Jul 2020
Question: Dear Doctors,
My father suffered a TIA 7 days ago and is currently in hospital. The surgeons believe an endarterectomy is too risky as the blockage is very high up the neck, and while a stent is another option it presents its own risks, too, because the presence of plaque along the arteries is quite high (it's 90% at the blockage site in the neck).
Is there a third viable option? They have mentioned just sending him home to be on medication only, but I am unsure how to weigh the risk of this against a stent. Any advice would be extremely welcome.
Thank you, XXXXXXX
doctor
Answered by Dr. Bhanu Partap (23 minutes later)
Brief Answer:
Please refer to the detailed answer below

Detailed Answer:

Hello

After going through the medical query raised by you and reviewing the details provided I can understand your concern and I would like to tell you that there are few factors to consider like the age group history of hypertension and diabetes along with Plaque in the carotid. All these factors increases the risk of complications significantly.

Our aim of treatment should be weighing risk benefit ratio and if risk involved in intervention goes higher than the expected benefit then treatment protocol should be Switched to alternative treatment options which in your case is optimal medical therapy as suggested by your doctor.

However still I would like to see the reports of the neck vessel scan done personally so that I can review any other possible way.

Kindly upload the reports.

Kind Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Bhanu Partap (5 hours later)
Thank you, Dr XXXXXXX

I have one follow up question for now. Would a solution perhaps be to do this in two steps? First take the medical therapy and then when some risk factors improve opt for the surgery? Does this make sense? How long might he have to be on medication for? Does it risk another TIA or worse in the meantime? Or does it prevent him recovering from this first TIA in any way?

Thank you again.
XXXXXXX
doctor
Answered by Dr. Bhanu Partap (4 hours later)
Brief Answer:
Hello again

Detailed Answer:
The risk factors are non modifiable. Neither we can revert the age nor we can make the diabetes disappear. So this doesn’t make any sense. Yes, there is always a risk of having another TIA but with optimal medication that can be reduced upto some extent.

Kind Regards

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Bhanu Partap

Cardiologist

Practicing since :2010

Answered : 4681 Questions

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Dear Doctors, My Father Suffered A TIA 7 Days Ago

Brief Answer: Please refer to the detailed answer below Detailed Answer: Hello After going through the medical query raised by you and reviewing the details provided I can understand your concern and I would like to tell you that there are few factors to consider like the age group history of hypertension and diabetes along with Plaque in the carotid. All these factors increases the risk of complications significantly. Our aim of treatment should be weighing risk benefit ratio and if risk involved in intervention goes higher than the expected benefit then treatment protocol should be Switched to alternative treatment options which in your case is optimal medical therapy as suggested by your doctor. However still I would like to see the reports of the neck vessel scan done personally so that I can review any other possible way. Kindly upload the reports. Kind Regards