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Nadim Al-Mubarak
Nadim Al-Mubarak, Doctor
Category: Neurology
Satisfied Customers: 379
Experience:  MD at University Hospital Case Medical Center
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My wife has FTD and has just learned that both Carotid

Customer Question

My wife has FTD and has just learned that both Carotid arteries are severely blocked and inoperable due to stenosis , however the window would possibly still be open had a ultra Doppler ultrasound or angiogram been performed earlier, she has had vascular Parkinsonism as well for more than seven years... What is your input?
Submitted: 1 year ago.
Category: Neurology
Expert:  DIEGO BONILLA replied 1 year ago.


This is Dr. Bonilla, experienced in Internal Medicine, Pulmonary and Critical Care.

I understand your concerns. Carotid stenosis can be treated by surgery. The main goal for surgery is prevention of stroke. It's important to consider the surgical risk, life expectancy and quality of life. It is reasonable to perform surgery when there is more than 70% stenosis of the internal carotid artery if the risk of perioperative stroke, infarct and death is low. All of these factors can be determine by the physician treating your wife. Let me know if you have any other questions. Please rate my answer.


Expert:  Nadim Al-Mubarak replied 12 months ago.


I am an expert in carotid artery disorder and treatment. I am happy to help you. The window for treatment is NOT close. I need more information to provide you with best answer.

  1. Has your wife had any prior Stroke or neurological symptoms (other than her symptoms of parkinson)?
  2. Was she given a percentage for the stenosis ?
  3. What exactly the specific reason given for the "inoperability" ? Very sever stenosis is not usually a reason to decline treatment unless it is 100% ?

Please let me know

Expert:  Nadim Al-Mubarak replied 12 months ago.
  • Based on the information you provided, the most likely reason for her inoperability is the Dementia. During surgery, large number of very small particles can move down-stream to the brain make her dementia worse.
  • Stent placement is a less-invasive alternative to surgery, but she would run through the same potential complication which is NOT negligible in either
  • In treating such a blockage in a patient like your wife with FTD, the risks and benefits of treatment need to be weighted, and in here, the risks very likely outweigh the benefits
  • No, doing US or angiogram ealier is unlikey to have changed the feasibilty of the treatment

Let me know if you have any further questions. If this answers your question, please complete the rating above. Best wishes