A Difficult Case: Patient needs carotid artery surgeryBMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6992.1450 (Published 03 June 1995) Cite this as: BMJ 1995;310:1450
- Graham Jackson, consultant cardiologista
- a Guy's Hospital, London SE1 9RT
This patient needs carotid artery surgery by an experienced vascular surgeon. He continues to develop neurological symptoms despite medical treatment and has a greater than 90% stenosis of the symptomatic left internal carotid artery. Without cardiovascular problems and if neurologically stable he has a less than 3% risk of morbidity and death. This rises to 10-15% if his neurological state continues to fluctuate at the time of carotid surgery. It follows that his management must be a joint effort.
His condition is complicated by recent unstable angina, for which …