Carotid artery

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Discussion

jasmine

Original Poster:

193 posts

186 months

Thursday 23rd April 2009
quotequote all
Can anyone tell me about the procedure used for unblocking the right carotid artery in an 84 year old man? I'd like to know what exactly it entails - is it keyhole (or whatever its called), is it done under a general, how long does it take, whats the expected recovery time and what exactly is done? I can't seem to make Google do the work for me today.

The many in question is very fit and active but his left carotid artery is 100% blocked and his right 70% blocked.

Thanks for any help smile

Driller

8,310 posts

283 months

Thursday 23rd April 2009
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Same as for coronal arteries I would have thought: wire through femoral artery and then either a stent or inflated balloon in the carotid.

jasmine

Original Poster:

193 posts

186 months

Thursday 23rd April 2009
quotequote all
Um, ok. Thanks.

Any other info anyone?

maddog993

1,220 posts

245 months

Thursday 23rd April 2009
quotequote all
This gives a decent overview; http://www.vascularweb.org/patients/NorthPoint/Car...

You don't mention his medical background but I would add that his advanced age goes against him risk-wise with such a procedure. However, we took in a similarly elderly chap the other day who had recently successfully had Carotid stenting and was getting on okay.



jasmine

Original Poster:

193 posts

186 months

Thursday 23rd April 2009
quotequote all
maddog993 said:
This gives a decent overview; http://www.vascularweb.org/patients/NorthPoint/Car...

You don't mention his medical background but I would add that his advanced age goes against him risk-wise with such a procedure. However, we took in a similarly elderly chap the other day who had recently successfully had Carotid stenting and was getting on okay.
Ok, that's brilliant, many thanks for that.

His medical background is quite simple - slightly low blood pressure but never been overweight, never smoked or drank to excess and always been extremely fit - retired Gurkha officer. His only major medical procedure (that I know of) was a bone graft taken from his rib to his skull when hit by shrapnel, but he was very young then.

I'm really grateful for the info on this - its always good to be prepared smile

maddog993

1,220 posts

245 months

Sunday 26th April 2009
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jasmine said:
maddog993 said:
This gives a decent overview; http://www.vascularweb.org/patients/NorthPoint/Car...

You don't mention his medical background but I would add that his advanced age goes against him risk-wise with such a procedure. However, we took in a similarly elderly chap the other day who had recently successfully had Carotid stenting and was getting on okay.
Ok, that's brilliant, many thanks for that.

His medical background is quite simple - slightly low blood pressure but never been overweight, never smoked or drank to excess and always been extremely fit - retired Gurkha officer. His only major medical procedure (that I know of) was a bone graft taken from his rib to his skull when hit by shrapnel, but he was very young then.

I'm really grateful for the info on this - its always good to be prepared smile
No problem. Sounds like the stenting should be a relative walk in the park for him then all being well. Hope it goes ok. smile

The_Doc

5,037 posts

225 months

Thursday 30th April 2009
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jasmine said:
Can anyone tell me about the procedure used for unblocking the right carotid artery in an 84 year old man? I'd like to know what exactly it entails - is it keyhole (or whatever its called), is it done under a general, how long does it take, whats the expected recovery time and what exactly is done? I can't seem to make Google do the work for me today.

The many in question is very fit and active but his left carotid artery is 100% blocked and his right 70% blocked.

Thanks for any help smile
They won't unblock the 100% blocked one

The problem is either insufficient flow, or emboli (clots flying off)

If it's 100% blocked then the brain is surviving on 0% flow from that carotid, and compensating on the other 3 main arteries (1 carotid and 2 vertebral) Also if it's blocked you can't shower off any emboli.

Narrowing of 70% in the presence of a 100% blockage on the other side needs treatment, and the options are Carotid Endarterectomy ( open up the tube and scoop out the crap) or an Endovascular arterioplasty (balloon) or stenting (fresh tube inside the artery)

All have siginificant risks, including CAUSING a stroke during the proceedure. The open operations can be done under general anaesthetic or just under local, the benefit of local being you can ask the patient to peform a task (eg squeeze a squeaky ball) during the procedure to make sure they haven't stroked-out. I kid you not. The endovascular stuff just involves numbing the point of needle insertion, usually the left groin (left femoral artery-> iliac-> aorta-> carotids.

Go and talk to the Vascular Surgeon in charge of the patient. I won't be giving any more information in this setting as it's just too inprecise

and I don't concentrate on arteries any more, I do bones, although I have cut many an artery in my time. hehe



and

jasmine

Original Poster:

193 posts

186 months

Friday 1st May 2009
quotequote all
Blimey! I'm not going to talk to anyone who's looking after my father - that would be an invasion of his privacy and entirely inappropriate.

Fortunately the consultant at Addenbrookes disagrees with you and the operation won't be necessary - it doesn't 'need' to be done apparently, and my father will be able to cope very well with the correct mediation.

ukdavvy12

182 posts

200 months

Friday 1st May 2009
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jasmine said:
Blimey! I'm not going to talk to anyone who's looking after my father - that would be an invasion of his privacy and entirely inappropriate.

Fortunately the consultant at Addenbrookes disagrees with you and the operation won't be necessary - it doesn't 'need' to be done apparently, and my father will be able to cope very well with the correct mediation.
The assumption was probably that if you post data about your Pa on an internet forum then you would probably accompany him to his stressful hospital appointment

And your reply also demonstrates what a poor medium the written/typed word is to convey gratitude when others take the time to help you out



The_Doc

5,037 posts

225 months

Friday 1st May 2009
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Every time I think about writing some advice in these forums my internal dialogue say, "don't bother, the message never gets across in a balanced fashion" But occasionally I think even some information can help...

I don't think I'll bother any more

Best wishes to the original poster and her family, and don't ask for medical advice in a forum.

moving on......

F i F

45,065 posts

256 months

Friday 1st May 2009
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Totally sympathise with the Doc's comment above. I'm amazed that 70% narrowed on one side with the other 100% blocked isn't being treated. There must be lot more to the story imo.

As an aside if anyone is actually facing an op such as carotid endarterectomy they can PM me via PH and I'll answer any questions off forum from the patient's perspective. (Will try and remember to check that email addy a bit more regularly, honest)

Briiefly, in my case, down to theatre early afternoon, back around 6-7pm-ish. By just after lunch the next day, bed stripped down, bag packed and registrar on his rounds looks in my direction and asks "wtf are you still doing here?"

Eagle Eye

21 posts

185 months

Friday 1st May 2009
quotequote all
The_Doc said:
Every time I think about writing some advice in these forums my internal dialogue say, "don't bother, the message never gets across in a balanced fashion" But occasionally I think even some information can help...

I don't think I'll bother any more

Best wishes to the original poster and her family, and don't ask for medical advice in a forum.

moving on......
Same here. I'm not a Doctor, but I still will only "give information" on standard stuff easily available on the internet (BP etc.).

Just gets thrown back...

jasmine

Original Poster:

193 posts

186 months

Tuesday 5th May 2009
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Men <roll_eyes>

If you're going to give information out in a pompous patronising way, its not really surprising when it gets thrown back at you. Especially when the info given isn't actually that useful. Don't worry, I've learnt my lesson I won't be asking a question I need a relevant answer to on this forum again, not judging by the latest replies including the one by the registrar. biggrin

I don't accompany my father on his every appointment as we live a considerable distance apart and he has four other children and a wife that are able to support him.

Its pretty pathetic and not a little stupid to suggest that there is 'something else going on' when the vascular consultant has said there's no need to operate - why on earth should there be anything sinister about a very experienced and skillful professional giving his extremely educated opinion? For goodness sake, get a grip.

Oh and contrary to what the registrar has said, only 15% of patients this procedure is carried out on benefit to any extent and at my father's age it is entirely appropriate to not put him through the op but to arrest any further blockage with medication.

And I thought women were touchy! Get a grip......

F i F

45,065 posts

256 months

Tuesday 5th May 2009
quotequote all
Blood and stomach pills, it's rarely that PH gets such an instant and epic attitude test fail!

In different circs worthy of a docs and vehicle condition fishing expedition to see how many extra sets of 3 pts can be earned.

The_Doc

5,037 posts

225 months

Tuesday 5th May 2009
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[/bothered]

Nubbin

9,067 posts

283 months

Tuesday 5th May 2009
quotequote all
jasmine said:
Men <roll_eyes>

If you're going to give information out in a pompous patronising way, its not really surprising when it gets thrown back at you. Especially when the info given isn't actually that useful. Don't worry, I've learnt my lesson I won't be asking a question I need a relevant answer to on this forum again, not judging by the latest replies including the one by the registrar. biggrin

I don't accompany my father on his every appointment as we live a considerable distance apart and he has four other children and a wife that are able to support him.

Its pretty pathetic and not a little stupid to suggest that there is 'something else going on' when the vascular consultant has said there's no need to operate - why on earth should there be anything sinister about a very experienced and skillful professional giving his extremely educated opinion? For goodness sake, get a grip.

Oh and contrary to what the registrar has said, only 15% of patients this procedure is carried out on benefit to any extent and at my father's age it is entirely appropriate to not put him through the op but to arrest any further blockage with medication.

And I thought women were touchy! Get a grip......
I think you've just demonstrated how neither sex has the monopoly on touchiness. You asked for medical advice on an open forum, and now you're getting all pompous and insulting when the information doesn't fit with what you want to hear. Your reply is unecessarily rude and arrogant.

Oh, and this is how you type rolleyes