Originally Posted By: stockrex
Greetings,
Grandma is a possible carotid stenosis on her right side. We have a CT scheduled for next week, with and without dye.
Problem is she does not tolerate CT dye very well, last time it was close one.
Anyone have any experience with Carotid blockage/narrowing?
How long ago was the CT scan where she had difficulty with the contrast? If it was a really long time ago, its possible she received Ionic contrast( renografin/conray etc). Ionic contrast caused nausea, vomiting , lowered blood pressure and in cardiac use , sometimes a-sytole. These would be non allergic reactions. An allergic reaction would be hives, itching, larygospasms, difficulty breathing, swelling of the tongue, dangerously low blood pressure, at that point we call it anaphylaxis.
Most procedures now, use non-ionic contrast media.( Isovue, Visipaque,Omnipaque.)
Knowing her age would help. Some patients are candidates for carotid stenting. Just remember the risk of stroke is there for any procedure, stenting or open. It is higher with age and calcified arteries. And if there are other co-mobitities. The atherosclerotic process is same disease , just a matter of where it is I.E. carotid, coronary artery, renal artery etc. The difference its the vessel size, what is down stream from it, how hard of soft the plague is( calcification). Whether the plague is eccentric, or concentric as well. lesion length comes into play, but usually less than 60-70% stenosis is left alone, but again lesion length matters as well as cross section area. Also how close it is or runs into the bifurcation.
Here is a image, as well as some anatomy.
[img:center]
https://www.nhlbi.nih.gov/sites/www.nhlbi.nih.gov/files/images_241[/img]
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https://qph.ec.quoracdn.net/main-qimg-e790caad5ed19e1b7037a45b19f635fe-c[/img]
Sometimes with advanced age, medical management can be the safest choice.