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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Surgery Essential For 90% Blockage In Carotid In Elderly?

Angiogram showed 90% blockage at origin of left internal carotid and left external carotid. 75 years old. Cardiologist recommended surgery....are there any other options other than surgery or stent. With 3 other arteries ok...is it necessary for surgery with the 90%? Thank you.
Wed, 18 Feb 2015
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Cardiologist 's  Response
Hello and thank you for your question! I understand your concern about surgery; seems that surgery is an important option (and generally is performed without frequent complications; I would say it is a routine intervention: you don't have to worry so much about that; of course another option is treatment with stent implantation; but you would need after that treatment with double anti-thrombotic therapy (aspirin plus clopidogrel) for a long time; the third option is to avoid the above two interventions and to be limited with the double anti-thrombotic therapy, but the incidence for developing stroke is high.
I recommend you amongst the three options mentioned above surgery as a more safe and steady intervention; is is not needed to insert foreign accessories in your body (stents) and more safe than the conservative option.
Hope to have been helpful to you! Greetings from Dr. Iliri
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Is Surgery Essential For 90% Blockage In Carotid In Elderly?

Hello and thank you for your question! I understand your concern about surgery; seems that surgery is an important option (and generally is performed without frequent complications; I would say it is a routine intervention: you don t have to worry so much about that; of course another option is treatment with stent implantation; but you would need after that treatment with double anti-thrombotic therapy (aspirin plus clopidogrel) for a long time; the third option is to avoid the above two interventions and to be limited with the double anti-thrombotic therapy, but the incidence for developing stroke is high. I recommend you amongst the three options mentioned above surgery as a more safe and steady intervention; is is not needed to insert foreign accessories in your body (stents) and more safe than the conservative option. Hope to have been helpful to you! Greetings from Dr. Iliri