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David Lucas — Carotid Artery Stenosis

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David Lucas has been playing the bass guitar since he was 16. Music is an irreplaceable part of his life – it’s “in his blood,” he says. Now 66, he plays part-time in a band and has a large collection of guitars.

“Being a musician – I always say, ‘it’s not who I want to be, it’s who I am,’” David says.

So, when he started experiencing periods of temporary vision loss and paralysis, he was scared. He didn’t want anything to interfere with his ability to play.

The Path to UPMC

For about one year before he sought treatment, David suffered periodic episodes during which one eye saw black for a moment, then returned to normal. With a history of macular degeneration, a disease that causes vision loss, in his family, he thought very little of the episodes at first.

“I just thought I had an eye problem,” David says.

Over time, however, the episodes worsened. Soon, when a temporary blackout hit, so did brief paralysis in his right arm and leg. Later, these episodes impaired his ability to speak and function for minutes at a time.

“The incidents would set me back for a whole day,” David says. “They kept getting progressively worse and progressively longer.”

But still, David says, he was stubborn. He remembers watching football on the couch with his wife one day when an episode happened. She asked him what was wrong, but he couldn’t speak or move at all. When the incident ended, his wife insisted it was time to go to the hospital, but he refused. It wasn’t until David suffered an episode at his job that he realized he may be experiencing strokes. That day, he shared his symptoms with a group of friends that included doctors, and they wasted no time telling him he had to get to a hospital right away.

“There were guys that were going to come and get me if I didn’t turn myself in,” David says.

But David’s band was opening for a national act in just two days – an amazing opportunity for the group, and one that could disappear if David wasn’t able to be there. He still wasn’t convinced a trip to the hospital was worth it. Instead, he went to a friend’s birthday party that evening as planned, only to be shooed back to his car by his friends, who told him he couldn’t waste any more time.

Wanting to seek treatment from a hospital he trusted, David drove himself and his wife to UPMC Passavant right away.

The Challenge: Carotid Artery Stenosis

Immediately upon admittance, the Neshannock Township, Pennsylvania, resident learned he wouldn’t be leaving the hospital any time soon. The hospital staff knew his condition needed serious attention. That night, David was transferred to UPMC Presbyterian, where he met Robert M. Friedlander, MD, chairman of the UPMC Department of Neurological Surgery.

Dr. Friedlander confirmed that David’s “episodes” were, in fact, mini-strokes, also known as transient ischemic attacks, or TIAs. He told David, a smoker of 40 years, that if he wanted to increase the likelihood that the treatments and outcome be successful, he had to stop smoking. That, David says, was just the first way Dr. Friedlander changed his life for the better.

Dr. Friedlander discovered a severe narrowing in David’s carotid artery that was causing the TIAs by blocking blood flow to the brain, a condition known as carotid artery stenosis. His condition was further complicated because at the site of narrowing there was a fresh blood clot. This condition is sometimes treated with surgery or using a stent to help restore blood flow, but the nature of David’s clot meant a stent procedure could kill him.

The Solution: Carotid Endarterectomy

Dr. Friedlander determined that a microsurgical procedure, called a carotid endarterectomy, to clear the artery and end David’s mini-strokes would be the safest and most effective treatment option. This involved making a small incision in David’s neck and removing all blockage from the carotid artery, restoring blood flow to his brain. UPMC neurosurgeons including Dr. Friedlander have many years of experience with endarterectomies, having performed thousands of them to prevent strokes that could cause serious brain or other damage.

The prospect of a surgical procedure was very scary, David says. But Dr. Friedlander put him and his wife at ease, explaining the surgery in detail and sharing his extensive experience with this procedure.

The Results: An Incredible Recovery

David made a complete recovery since his surgery. After his discharge, he received support from his wife and Dr. Friedlander’s staff throughout his recovery.

“The nurses on the floor were just fantastic,” David says. “They pushed me as hard as anyone could be pushed because they knew it was my goal to get out and go home.”

Now, David has no adverse effects from either his TIAs or the surgery. The very first thing he did when he arrived home was pick up his bass – and he could play it perfectly.

“It was probably the one thing I was most concerned about after the surgery,” David says. “But to be able to do what I had done since I was 16 years old – it was exhilarating.”

In fact, he believes his quality of life today is far better than when he entered the hospital.

“I love life. I’m able to be here with my wife and my dog and enjoy time with my children and grandchildren, able to do all of the hobbies that I like to do,” David says. “Given that I had a near-death experience, I’m grateful every day. UPMC and Dr. Friedlander saved my life.”



Our patient stories profile a number of patients who have had minimally invasive brain surgery at UPMC. Although everyone's care experience is unique, we hope that sharing these stories will help other prospective patients and their families better understand these procedures and their potential benefits.

David's treatment and results may not be representative of all similar cases.

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