Suggest treatment for internal carotid stenosis
In the follow up check done in July, the same doctor advised continuation of the same medicines and advised check up after 6 weeks. In September, when he was taken for the check up, the doctor advised continuation of the same medicines and discontinued the use of metaspan. He was asked to come for a checkup in October after getting a carotid doppler done.
A carotid doppler study was done on 13th october which showed partially calcified plaques involving carotid bulbs , bilateral proximal external and internal carotid arteries causing moderate to near complete stenosis(75%-99%) of proximal left internal carotid artery and mild to moderate( 50-70%) stenosis of proximal right internal carotid artery.
If I compare the carotid doppler done while he was admitted in the hospital against the one done in october it would be apparent that the blockage has increased. I am getting the feelings that the medicines prescribed by the doctor are not having any effect.
Considering the situation, his age and overall health condition, can you please let me know what is it I need to do ? I would need some guidance on the various options that are feasible at this stage and what are chances of success?
Continue same medicines/vascular surgeon's opinion.
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I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I have gone through your father's clinical details as mentioned above.In the present scenario,for internal carotid stenosis-a vascular surgeon's opinion should be taken regarding 'endarterectomy'.Please discuss with the treating neurologist regarding this, as well.
Meanwhile,medicines are to continue as such.Medicines have more of a preventive role than curative.Further,it is not confirmatory whether inspite of taking medicines,disease will progress or not.Progression depends on many risk factors.But one thing is sure,that if the medicines are discontinued-it will cause more harm.Medicines as prescribed are fine and according to treatment protocol.
If you have further questions,I shall be glad to have you in follow-up.
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