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What Does "chronic Small Vessel Ischemic Changes" Mean?

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Posted on Fri, 4 Jul 2014
Question: I had carotid artery surgery two weeks ago after having 3 TIA'S in a week. On the CT scan report and the MRI report it stated that I had chronic small vessel ischemic changes and atherosclerotic calcification of the visualized distal internal carotid arteries and distal left vertebral artery. Do I need follow up care and what does this mean. I am female 61 with history of PAD CAD Quadruple bypass and aorta femoral bypass.
doctor
Answered by Dr. Dr. Ivan Romich (7 hours later)
Brief Answer:
Hi and welcome to HCM

Detailed Answer:
This is not something unusual. During carotid surgery, we remove the biggest atherosclerotic plaque in carotid artery bifurcation. It means that we try to decrease size of this plaque so that in future possibility of embolus is minimized. It is impossible to remove all atherosclerotic changes especially in vertebral artery and in the end of internal carotid artery since these vessels are deeper in skull and neck structures. So after surgery, it is possible that small thrombus are ripped of and it can cause TIA again,so some time need to pass for these thrombus to be dissolved.
For small ischemic changes and calcifications there is no need for surgery. you just need to treat this by controling your blood lipids, blood sugar, take aspirine, regulate body weight. Wish you good health. Feel free to ask. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Ivan Romich (6 hours later)
My question was what does small ischemic changes etc. mean, and that question was not answered.
doctor
Answered by Dr. Dr. Ivan Romich (5 hours later)
Brief Answer:
Hi

Detailed Answer:
It means that on CT scan they saw chronic permanent small vessels damage due to ischemia(blocked b lood flow) and this ischemia is caused by atherosclerosis. This is common finding in people at your age who are suffering from atherosclerosis.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Ivan Romich

General Surgeon

Practicing since :2008

Answered : 13888 Questions

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What Does "chronic Small Vessel Ischemic Changes" Mean?

Brief Answer: Hi and welcome to HCM Detailed Answer: This is not something unusual. During carotid surgery, we remove the biggest atherosclerotic plaque in carotid artery bifurcation. It means that we try to decrease size of this plaque so that in future possibility of embolus is minimized. It is impossible to remove all atherosclerotic changes especially in vertebral artery and in the end of internal carotid artery since these vessels are deeper in skull and neck structures. So after surgery, it is possible that small thrombus are ripped of and it can cause TIA again,so some time need to pass for these thrombus to be dissolved. For small ischemic changes and calcifications there is no need for surgery. you just need to treat this by controling your blood lipids, blood sugar, take aspirine, regulate body weight. Wish you good health. Feel free to ask. Regards