Severe Blockage In Cartoid Artery. Had A Nuclear Stress Test And Undergone Angioplasty. Further Treatment?

Posted on Wed, 25 Sep 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 25 Sep 2013 Answered on

Tue, 22 Oct 2013 Last reviewed on

Question : I have a sever blockage in my r carotid artery and also some blockage in the left. I had a nuc stress test that didn't show anything with the heart - however, they had to give the last injection @ a HR of 141, as I was having pain (3 on scale) trying to achieve the 143 HR number for final nuc injection, That being said, the heart appeared fine.
Doc want a CT angio w/ XXXXXXX and also angioplasty to rule out anything they may have missed. My question is why don't we go right to the clogged artery surgery and/or stent since we know that's where the problem is. What are the reasonings for another test on the Artery w/ dye? It seems like the biggest fire should be put out first??
Anxious and confused !

Answered by Dr. Ravindra Setty B.R. (11 hours later)

Brief Answer:
Please get the test done.

Detailed Answer:
Dear maam,

As you have lesions in your carotid arteries, you may also have lesions or blocks in your coronary arteries. It is better you get your heart checked up fully before the intervention for the carotid arteries are done. Since CT angiogram is a non invasive procedure, it gives an opportunity to avoid angioplasty if there are no blocks found on angiogram. But if present both can be tackled at the same time.

I hope this allays your fears and confusion.

All the best with your treatment.
Dr. Ravindra Setty

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ravindra Setty B.R. (7 hours later)

Hello, Thank you for your response. I think I follow you, but am not clear on your sentence since CT angiogram is non invasive it give an opp to avoid angioplasty. The CT is of the coratid artery - not the heart. so, how would that give an opp to avoid heart angioplasty? Also, I am hearing that it's better to make sure heart good, prior to carotid artery surgery, correct? How common is the carotid artery surgery/stent? and how do you determine which surgery for the carotid to get? It seems the stent is way less complicated?
Thank you SO very much !! Jodi

Answered by Dr. Ravindra Setty B.R. (3 days later)

Brief Answer:
Hi, sorry for the delay.

Detailed Answer:
The CT angiogram is for the heart to rule out any lesions in the heart. stenting for the carotid arteries is the better option.
Thanks,
dr XXXXXXX setty.

Above answer was peer-reviewed by : Dr. Shanthi.E