Conversation: The conversation between human and AI assistant.
[|Human|] hi doctor: im 46 years male from iraq.smoker.hypertensive.diabetic.and positive family history of ischemic heart disesase. befor one mounth i had a TIA in my left side persist for about one minute in form of parasthesia and weakness. doppler study show 60% stenosisi in the rt carotid artery with a pluqe about 15 mm. ct carotid angio proved same changes.. yoyr openion about doing rt carotid endarterectomy. ct coronery angio showing 60 % stenosis in the proximal rt coronery artery.
[|AI|]  Hello. Thanks for posting here. I have gone through your description. 60% blockages are considered non-critical. The carotid arteries supply the brain. When you had a TIA a small clot may have been formed at the blockage area and later traveled towards your brain. So you need to be on antiplatelet medications which will prevent the clot from forming. Endarterectomy is usually not done for 60% stenoses. In the future if the block increases in severity, a carotid stenting can be offered. Endarterectomy is a surgery and usually is done if angioplasty fails or is not possible. At present, you need to be on medical management. Also, the RCA has a 60%stenosis which again is non-critical and should be managed on medications. You should be prescribed antiplatelet medications and statins which lower the cholesterol to prevent these cholesterol deposits in your arteries from increasing. You have many risk factors for heart disease like smoking, high BP, diabetes, so you have to continue your BP and diabetic medications along with the above and try to quit smoking. Wishing you Good healthRegards.