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My wife had a mini stroke on Friday, over in a very short time. GP sent her ecg to the hospital where we spent Saturday 2 mri scans (1 head 1 carotid artery) + ultra sound on carotid artery. A 69% restriction was found in the carotid artery.
She has received an appointment in the endoscopy dept on Friday. What is the likely course of action? Thanks in advance
IIRC either scraping the blockage out or putting in an expanding tube ( a stent) into the narrowed bit. Done by passing a wire thru an artery and then feeding it thru the sytem to the right place. all done under clever imaging so they can see what they are doing.
https://medlineplus.gov/ency/article/002953.htm
If it were my family member I'd hope the appointment was to see a vascular surgeon. They should be considering carotid endarterectomy - posh name for the operation mentioned above. NICE guidance is that it should be done within 14 days from onset of symptoms.. Obviously depends on clinical details which may affect treatment decisions and options.
To add to that, carotid stenting (that link above) is less common in the UK as open surgery is felt to get better results unless there are special reasons to stent.
COI consultant anaesthetist who regularly provides anaesthesia for this operation. 6028115
The short answer is as above
The long answer is 'it depends'. A 69% stenosis may or may not be relevant depending on how they measured (NASCET vs ECST) and only if on the same side as her symptoms. It'll also depend on other factors like blood pressure, diabetes, ECG, the MRI results etc.
Basically you need to have a conversation with a stroke physician or a vascular surgeon. Go armed with information about carotid stenting and endarterectomy.
I have no idea why you have to go to endoscopy though.
No idea but good luck to you both.
The scan results were sent to the vascular team for assessment. Will be 7 days from the episode on friday. Currently on asprin and statins, worst of all no driving for a month!
Endoscopy lab could be where they do all the cardiac catheterisations? wouldn't be too odd to run the two depts together would it? At my local hospital its called the catheter lab where they do stents
Yes, but the cath lab has lots of X-ray equipment in it (and lead walls), unlike endoscopy which is basically a normal operating theatre. I don't think I've worked anywhere where they've been co-located.
Tommyo: glad one of us has read the GMC guidance on social media.