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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Carotid Artery Stenosis

My 70 yr old husband has just received a diagnosis of carotid artery stenosis. ultrasound report shows 80-95% occlusion of the left carotid artery in his neck. (30-45% on right side which I understand is within normal rang for that age.) he has low grade diabets and is being treated for this now. high blood pressure( maintanance w/ prescription treatment for several yrs. keeps him in relativly normal range ) Has very bad sleep apnea for many years, won t wear the breathing apparatus, has tried, (sever clostraphobic ).has had numbness in his fingers for a couple of years, even had carpal tunnel on hand w/o change, White male, 5 9 , wt. 222 lbs. very inactive, smokes 1 1/2 packs cigaretts a day , has most of adult life (I was trained respiratory therapist just out of college!) yes I know how bad this picture is, I m waiting for a stroke or worse. This report has gotten his attention. ( not to stop smoking of course) These test all happened via his new primary care MD, last year we relocated to another state and are just now getting settled . He has an app. W/ cardioglist in 3 days. I m assuming they will do a procedure. My real question, for the last couple of mos. he is experencing a lot of tiredness during the day and falls asleeps 2-4 hrs. At a time. He says he is sleeping during the night (is up and down a lot to bathroom , but mostly sleeping) .in your opinion , Does this carotid artery stenosis cause tiredness or is the sleep apena catching up with him from lack of oxygen or, what?
Tue, 5 Jan 2021
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Anesthesiologist 's  Response
Hello,

The carotid artery stenosis and the sleep problem can be two different issues. As you have mentioned because of the sleep disturbance at night he is tired all through out the day. Sleep apnea causes high carbon dioxide levels in blood. This can result in tiredness. He should continue his breathing apparatus use at night so that the day time sleepiness and tiredness can be reduced to some level.

The other issue is the carotid artery stenosis. As there is 90% stenosis he should undergo a surgical procedure known as Carotid endarterectomy. Before the procedure his cardiac evaluation needs to be done as there is disease in carotid arteries there can be chances for coronary artery disease as well. Hence cardiac evaluation is required for the procedure. The underlying cardiac disease can also be the cause of his tiredness.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Meera Rajeev, Anesthesiologist
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Suggest Treatment For Carotid Artery Stenosis

Hello, The carotid artery stenosis and the sleep problem can be two different issues. As you have mentioned because of the sleep disturbance at night he is tired all through out the day. Sleep apnea causes high carbon dioxide levels in blood. This can result in tiredness. He should continue his breathing apparatus use at night so that the day time sleepiness and tiredness can be reduced to some level. The other issue is the carotid artery stenosis. As there is 90% stenosis he should undergo a surgical procedure known as Carotid endarterectomy. Before the procedure his cardiac evaluation needs to be done as there is disease in carotid arteries there can be chances for coronary artery disease as well. Hence cardiac evaluation is required for the procedure. The underlying cardiac disease can also be the cause of his tiredness. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Meera Rajeev, Anesthesiologist