An interventional cardiologist’s’ perspective was needed in a medical malpractice case after a fifty year-old woman passed away from complications arising in her carotid endarterectomy procedure. Two years after her left carotid artery underwent endarterectomy to reduce her risk of strokes, the woman was admitted to Emergency services after complaining of left-sided weakness, difficulty walking, slurred speech, and signs of increased confusion. She was initially diagnosed with a stroke, though a CT scan could not picked up any signs of one occurring. After admittance to the stroke unit, doctors placed her on stroke protocol and recorded that she needed a carotid endarterectomy in her right internal carotid artery to facilitate regular blood flow. Based on her history, however, she was first given a stress test that determined she would need a procedure to unblock her coronary arteries with a stent placement. When operating to place the stent, the woman’s blood pressure dropped precipitously, causing her to die from an iatrogenic hemorrhage.
Question(s) For Expert Witness
1. How frequently do you perform cardiac interventions similar to that described in this case?
2. Have you encountered a case such as this, wherein the patient presents for urgent cerebrovascular concerns but possesses a concomitant cardiovascular risk?
Expert Witness Response E-056274
I routinely perform coronary interventions and treat patients with carotid disease. I am frequently involved in perioperative risk stratification for patients who need to undergo carotid artery interventions and surgery. I have lectured and published on this subject matter, but not specifically the scenario of carotid disease in conjunction with coronary arterial disease.
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