Carotid stenting: is a coronary angiogram necessary?

@springtime1, according to this information from Mayo Clinic:
"Carotid angioplasty is often combined with another procedure called stenting. Stenting involves placing a small metal coil (stent) in the clogged artery. The stent helps prop the artery open and decreases the chance of it narrowing again. Carotid angioplasty and stenting may be used when traditional carotid surgery (carotid endarterectomy) isn't possible, or it's too risky." Read more here https://www.mayoclinic.org/tests-procedures/carotid-angioplasty-and-stenting/about/pac-20385111

Fellow members @goincd1 @keithl56 @lioness @marciabl @vic83 @retirement75 @artist01 may have experiences and tips to share. Also see these related discussions:
- Medication vs. Stent treatment for coronary artery disease: https://connect.mayoclinic.org/discussion/medication-vs-stent-treatment-for-coronary-artery-disease/
- Questions about diagnosing carotid artery disease https://connect.mayoclinic.org/discussion/carotid-artery-disease-diagnosis/

Springtime, it's not easy to be a long distance caregiver. Is your father recovering well after the TIA? Does he live alone?

@springtime1 I'm not able to help you with stents.My arteries where to small .They tried a balloon but it collapsed in 3 months so I had open heart

Interesting question. Your father had a stroke so they will treat the Carotid artery issue which supplies oxygen to the brain. And the suggested angiogram would be to see if there is a similar problem with the coronary arteries. which provide oxygen to the heart. I wonder if that is normal procedure to do an angiogram at the same time? And is your father having chest pain?
In my case (I am 80 years old) in the last year 1) I have plaque buildup in my carotid arteries but below 50% so not enough to do anything 2) I had normal EKG and Echo-Stress tests a few months before, but an angiogram showed I have 70%-80% blockage in a coronary artery. I still have a normal EKG and Echo-Stress test
I had gone to ER for something else, and blood work showed elevated Troponin and they suggested angiogram. It found several small blockages and one major (70%-80%). In the US a minimum of 70% blockage is required to place a stent. Since I had a lung mass that very likely would require surgery, I did not do a stent, but went on medication to relax arteries and lower fats (Atorvastatin 80mg, Imdur, isosorbide mononitrate, metoprolol succinate, low dose aspirin, indapamide). Stenting requires the patient to take anti-platelet medication for many months and surgery while under such medication is an issue. I just had a call with my Cardiologist, and I will remain on medication and not do stent, because I have potential for more lung surgery. I have no chest pain so it is considered stable angina. The medication option exists because of the recent Ischemia study.
https://www.health.harvard.edu/blog/medications-as-effective-as-stents-for-most-with-coronary-artery-disease-2019120918513

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Hi Springtime, I just thought I would add my own experience about angiography and the need there of. I personally don't have a problem that requires a Stent but because of a condition that seems to be prevalent in Heart Transplant Patients like me our heart vessel can become restricted due to a type of inflammation. So due to that I have had an angiography every year for the first 5 years of my new Heart and I just had my 4th done last month, now granted I'm only 63 but my take on this is if he already has one blockage then the thought I would have is maybe there are more so why not. The procedure takes all of 15 min and is not very invasive so I'm thinking if they are already doing the Stent why not do the angiography at the same time. He will be already in the hospital and it may not even need to move him to another OR, in the states angiography are done in the cat lab due to needing a special xray machine but I think it's the same machine they use for stents since they need the xray to place the Stent. So maybe ask those questions about the complexity of doing both together.
I do remember once when I was having a angiography as a routine checkup, this was prior to the transplant, My Cardiologist told me actually if during the angiography they saw something that need to be addressed they would send a seperate team in to do a Stent so I do now that in the US they will sometimes do a discovery Angiogram to see if there is a blockage and be ready to take care of it immediately. Hope that helps
Blessings