Q: I had a mild stroke and have 40% blockage on the right side.   Is there anything that I can do to unblock my carotid artery, and how dangerous is this?

There is no evidence currently to suggest that fixing mild blockages in the carotid artery (less than 50 percent blockage ) is of any benefit. The evidence currently points to a benefit only in patients with 60 percent and greater blockage with symptoms, and in those with very tight blockages (more than 80 percent) regardless of symptoms, that carotid surgery - or in selected cases, angioplasty and stenting - is of benefit.

What is more important in this case is to be on the right medicines (aspirin or Aggrenox, depending on what your neurologist wants), definitely a cholesterol-lowering agent like statins (to keep bad cholesterol LDL less than 100), and good, long-term control of blood pressure (less than 135/85).  Also important is a good control of diabetes and not smoking, as well as a healthy lifestyle and diet.

As long as the blockage is mild, there is no reason to unblock it. Doing so poses a higher risk of complications than benefit.

Karthikeyan Ananth, M.D., is a cardiologist at Henry Ford Hospital in Detroit.  His clinical interests include congenital heart disease, echocardiography, nuclear cardiology and cardiac imaging.