Seeking Best Choice for Carotid Artery Surgery

Tom Lisella doled out plenty of advice over a 42-year legal career, but one of his most important pieces of guidance can’t be found in any law book.

“You have to be your own health advocate,” the retired estate and real estate attorney says. “You have to swim in an ocean that’s different from your normal existence.”

And swim, he has, including researching Lehigh Valley Heart and Vascular Institute vascular surgeons to determine who he wanted to address plaque in both of his carotid (pronounced kuh-rot-id) arteries, one of which was nearly 80 percent blocked by plaque, a substance that can build up on artery walls. In this case, the plaque can potentially break off and cause a stroke.

A voracious reader, Lisella says he reads about an extensive range of topics, medical journals included.

Your carotid arteries, about a quarter-inch wide, carry blood and oxygen to your brain and you have one on each side of your neck. Men typically have larger carotid arteries than women. They can become clogged with plaque just like your coronary arteries and need to be addressed to prevent a future stroke.

Carotid artery disease causes up to one-third of all strokes. Lisella, 74, of Hometown, Schuylkill County, was a smoker for 30 years and smoking is a risk factor for both carotid and coronary artery disease.

A founding partner of Bowe, Lisella & Bowe in Tamaqua, Lisella says he wanted a vascular surgeon to perform the necessary procedures on the carotid arteries in his neck. “I started looking at Lehigh Valley Heart and Vascular Institute vascular surgeons and then I looked at their published works,” he says.

He chose Mila Ju, MD. “I was very impressed with her publications,” he says.

Due to the COVID-19 pandemic, he met Dr. Ju virtually at first and said there was a quick rapport. “She knew I had prepared myself,” Lisella says. “She was a little surprised at some of the questions I asked.”

Lisella had stenting done to address the plaque in his carotid arteries instead of open surgery. Dr. Ju says the physical location of Lisella’s blockages – near his jaw – made stenting the safer option. In a stenting procedure, a surgeon uses a short hollow tube to help place an expandable mesh tube in the plaque area to prevent plaque from breaking off and leading to a stroke. “Stenting has very favorable results,” Dr. Ju says, adding success rates are comparable to the more invasive open surgery option.

“Deciding on which option to pursue comes down to a number of factors, including the extent of the carotid artery disease and patient preference,” Dr. Ju says. “A lot of things go into the decision.”

Lisella’s left carotid artery was stented in February 2021. While waiting for that to heal before addressing the right carotid artery, Lisella scheduled a colonoscopy. But just before he was to undergo that procedure, he suffered a mini stroke, also known as transient ischemic attack (TIA). He recalls being asked his name, but not being able to respond. “I turned my head and looked at my wife. I thought I was speaking, but I’m now convinced I wasn’t. I’ve had morphine before, and it was like being under the influence of morphine.”

Lisella says he was quickly taken to the emergency room and given clot-busting medication. He was discharged a brief time later, and in December 2021 he had his right carotid artery stented.

Lisella, chairman of the board of directors for Mauch Chunk Trust Company, said he was impressed by Dr. Ju and all the staff who supported him. “The entire staff had such respect for Dr. Ju. I just felt confident in her care,” Lisella says.

Lisella continues to do well on the carotid artery front. Dr. Ju monitors his carotid arteries and is also monitoring a small aortic aneurysm. Lisella says he had an aunt who died of a ruptured aortic aneurysm, so he’s glad that’s being watched.

“Knowing you’re doing the most you can for your health improves your outlook on life. I’ve seen people my age who’ve neglected their health and their life experience has been diminished.” - Tom Lisella

The carotid artery stenting wasn’t his first cardiovascular procedure. He previously had cardiac ablation for atrial fibrillation (AFib) and underwent heart bypass surgery in 2015, during which he suffered a stroke (unrelated to his carotid arteries) that affected his eyesight and ability to read. He had to learn to read again, and he still can’t look at a computer screen for extended periods of time.

Like the fictional Perry Mason who won every case, Lisella’s determined to prevail against the health challenges in his life.

“It’s more than a new lease on life. It really affects your outlook,” Lisella says of having his carotid artery disease addressed. “When you’re 74, you’re looking down the tunnel. You don’t want to get there, but you can see the end of it. Knowing you’re doing the most you can for your health improves your outlook on life. I’ve seen people my age who’ve neglected their health and their life experience has been diminished.”

Lisella averages about three days a week working for the bank. He’s the father of four and the grandfather of five. He and his wife, Dianne, have a love of travel and have been to 38 countries so far. He’ll no doubt continue to take his own advice and advocate for his health (a hip replacement is in his future).

“Helping someone avoid a potentially catastrophic stroke, improving their quality of life, that’s what’s so satisfying about what we do in these cases,” Dr. Ju says. “Partnering with you to get the best results is who we are as a Heart and Vascular Institute and a health network. We’ll always advocate for what’s right for you.”