If a doctor says your carotid arteries require surgery, it's time for a second opinion

About 20 years ago, an older friend of my father’s had surgery on his carotid arteries.

I’d never heard of carotid arteries. To my untrained ears, it sounded like “corroded” arteries. I knew THAT couldn’t be good. And I couldn’t imagine how surgery could fix your arteries if they were corroding.

It turns out, on that last point, I wasn’t far from wrong.

If a doctor says you need some work done on your carotid arteries, two words should leap to mind…

Red. Flag.

Fixing the pipes

When surgeons go wild, they don’t party hard, showing off their scalpels. They just quietly cash checks they shouldn’t be cashing.

That seems to be what’s happening when it comes to “fixing” carotid arteries.

The carotid arteries are two large blood vessels on either side of your neck. They deliver blood to your head and brain. So a narrowing of either artery raises your risk of stroke.

In the 1950s, surgeons began opening the arteries to remove blockages. Risky? Oh my yes.

About 3% of patients experience a stroke or heart attack during surgery. But trials show that this procedure reduces risk of stroke by only 1% to 5% over five years. That’s why doctors only recommended it for patients at highest risk of stroke.

Well… That’s the “perfect world” scenario.

Oxford Neurologist Peter Rothwell says the practice is quite a bit different. In fact, his research reveals a shocking reality. Only two of every 10 patients who have this surgery are appropriate candidates. Some patients don’t even have symptoms linked to blocked carotid arteries!

In recent years, surgeons have been using a less invasive stenting technique. This would seem to be safer than actually cutting the veins open. But researchers stopped a 2006 study of the procedure when death rates soared higher than expected.

Another study found that within four years after treatment, more deaths occurred among those who received stents than among surgery patients.

Yet, in spite of these dangers, stenting carotid arteries is on the rise.

Don’t get caught on the wrong end of this scheme. If a doctor recommends either of these invasive procedures, remember… Red flag!

Time for a second opinion.

“The Problem With Medicine: We Don’t Know If Most of It Works” Jeanne Lenzer and Shannon Brownlee, Discover magazine, Published online 2/11/11, discovermagazine.com

“Endarterectomy versus Stenting in Patients with Symptomatic Severe Carotid Stenosis” New England Journal of Medicine, Vol. 355, 10/19/06, nejm.org

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