Dear Dr. Roach â¢ I have a carotid artery problem. My right side is 79 percent blocked, but the left side is clear. My eye doctor said that surgery would not be necessary because the left side could take over if the right side is blocked. My regular doctor will neither confirm nor deny this. I am 85 years old and would like to avoid surgery. â J.L.W.
Answer â¢ Although there are connections between the left side and the right (the communicating arteries in the circle of Willis), a significant blockage on one side puts you at risk for a stroke on that side, even if the other side is clear.
In general, surgical treatment is only recommended for people with a life expectancy of at least five years, who have a significant blockage (depending on the guideline, âsignificantâ ranges from greater than 60 percent to greater than 80 percent) and who have access to a center where the risk of death or stroke from the surgery is less than 3 percent. In people who are at high risk from surgery, placing a stent in the carotid artery may be an alternative; however, standard surgery (carotid endarterectomy) is the preferred approach. People with symptoms from the blockage or a history of prior stroke (or a TIA, which is a temporary stroke-like syndrome) are at much higher risk.
The average 85-year-old man has a life expectancy of about six years: Yours may be less or (hopefully) more and depends on your other medical conditions, genetics and lifestyle.
I spent a lot of time trying to get specific information on rates of complications with this surgery from the hospital compare section of the publically available Medicare database, but I could not get anything more than an overall star rating (1 through 5) for hospitals. I would like exact numbers in order to choose the best hospital in my…