Advances for Carotid Disease
By Neil Goyal, MD, Instructor in Clinical Medicine, Columbia University and William A. Gray, MD, Director of Endovascular Services New York -Presbyterian Hospital, Columbia University.
Stroke is a leading cause of severe disability and the third leading cause of death in the U.S. Despite medical advances, about 700,000 Americans suffer a stroke each year. When a stroke occurs, people may feel sudden onset of weakness in a limb, numbness, difficulty speaking or even a generalized change in behavior.
Rapid medical attention is needed to deliver therapy to help allow brain recovery and prevent recurrent strokes. Physicians now have a variety of options, both medical and surgical, to treat and prevent this potentially devastating complication of cardiovascular illness.
Sources of stroke
Most strokes are caused by emboli, small blood clots that travel to the brain and prevent the normal delivery of oxygen-containing blood. Sources of emboli include the heart itself, the aorta, and the carotid arteries. In some people with an irregular heart rhythm called atrial fibrillation, clots can form in a chamber of the heart and then travel to the brain causing a stroke. The aorta, the largest artery in the body, can develop plaque accumulation that can also break off and travel to the brain.
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Last Saturday, I’d been struggling with an entire week above 200 that just didn’t seem to want to budge. So I decided that I couldn’t risk the Omnipod anymore and I had to pull it from my management routine, at least until things settled down. I started twice-daily Lantus injections on Saturday night and have been working out the kinks of being back on MDIs since then. The first three days of switching to MDIs were rough. Watching the Lantus take effect slowly was like waiting for...