What are my risks of repeated stroke with surgery?

A fellow caregiver asked...

The surgeon says it is absolutely necessary for a hernia (in my groin) to be repaired ASAP. I am on aggrenox and have been told it will be bridged with lovenox before/after. I'm scared of having another stroke. I'd like to know my chances.

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

If the surgery is absolutely necessary, you should go ahead and have it. As is the case with almost all surgeries, the surgeon prefers you be off blood thinners during the operation.

Aggrenox should have a very short lifetime in your blood stream, so many surgeons are ok with holding that medicine for only a day or two before the surgery. I would check with the surgeon about whether you can take that medicine up until only a few days before the surgery to minimize the chance of a stroke.

With regards to the Lovenox, there are a few different doses of that medication, so it is hard to say if it would cover you sufficiently for a stroke. There may simply be a few hours where you are not on blood thinners at all - this is usually not a major risk.

With regards of your risk of having a stroke during the surgery, it is very difficult to say without knowing the state of your arterial system. If you have a lot of cholesterol plaque, you are at higher risk. If that is the case, you should continue to take your cholesterol medicine to help stabilize those plaques and keep your stroke risk low. Overall, the chances of having a stroke during sugery are rather low.

Good luck!