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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Why Is The Right Carotid Artery Non Operative?

I have a sister who is 57. She has just been diagnosed with severe ascvd. She is having surgery tomorrow for sent placement in legs, pelvis and possiblly heart. The is having heart cath tomorrow, too. Her recent brain MRI showed that she has 2 areas in the brain that show past history of stroke. She has 70% occusion in left carotid and 100% i right carotid. Her surgeon called her this am and told her they cannot do anything to open right carotid up. What is the reason?
Tue, 5 May 2015
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Neurologist,  's  Response
I read your question carefully and I understand your concern.

The reason one intervenes on a carotid artery is to prevent it from releasing emboli, blood clots which could travel to the brain circulation and cause a stroke. That risk is higher when you have a severe, say 70-90% stenosis, but if it's totally occluded then it won't release any emboli in the circulation so there is no gain, on the contrary the surgery itself might cause a stroke in the early period after surgery.
Whatever damage that carotid artery could have done is already done, now the circulation in that area of the brain is maintained by communication with the vessels on the other side and the posterior areas of the brain.

I hope to have been of help.
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Why Is The Right Carotid Artery Non Operative?

I read your question carefully and I understand your concern. The reason one intervenes on a carotid artery is to prevent it from releasing emboli, blood clots which could travel to the brain circulation and cause a stroke. That risk is higher when you have a severe, say 70-90% stenosis, but if it s totally occluded then it won t release any emboli in the circulation so there is no gain, on the contrary the surgery itself might cause a stroke in the early period after surgery. Whatever damage that carotid artery could have done is already done, now the circulation in that area of the brain is maintained by communication with the vessels on the other side and the posterior areas of the brain. I hope to have been of help.