Carotid Stenosis Improvement. Say What?!

To see the history of my carotid stenosis, all you will have to do is click the “carotid stenosis” label to the right of this blog. That should pull up all my previous posts on what the findings were in my many carotid ultrasounds, over the years. You will notice that since 2011, when I started documenting this, they have been worse every year. I believe I started with a 40-60% stenosis, which moved to 60-70% after a couple of years, and all the way close to a 90% blockage last year, before my heart surgery.

This week, I had my annual carotid ultrasound and vascular surgeon appointment, and for the first time ever, there is no progress in my stenosis. The narrowings are at the same percentage as last year, according to the PA. The vascular surgeon agrees, and even said “I will call them the same, because I am too nervous to really say they are a little better.” What?! “Better”?! They did not even bring up the one spot that had a 90% blockage last year. After 40+ years of clogging up my arteries and living with high cholesterol that has not been anywhere near normal limits, is there such a thing as an improvement or even a lack of change in my narrowings?! I am still in shock, and unsure whether to be thrilled about it or ask “what's next?!”

The only thing that is different this year is the fact that I have been taking a pcsk9 inhibitor drug (mine is 150 mg of Praluent every 2 weeks. I am not endorsing it, it is just what was prescribed to me). Drugs in this class promise to do wonders not only in our cholesterol levels, but also in reversing atherosclerosis. So, I guess the conclusion is: they are working.

I was told that the earliest you can see a change or reversal in the deposits on your arteries is after about 70 weeks since starting the pcsk9i drugs. I have about 61 weeks of Praluent behind me, and the verdict is that there has not been more damage added to my carotid arteries during this time. I will take that as a cautious win, of course, but I am still in shock.

Of course, I am still wondering what else (bad) is this drug doing to me besides improving my cardiovascular life, but I cannot dwell in fear of that. I am making the best decision with the information I have now, and will hope for the best.

There is still the risk of the carotid plaque having hardened the carotid wall, and continuing to do so, but at this time they said the blood velocity is good, so they are not suggesting surgery or repairs. Unless I develop an aneurysm, there is no surgery to be done, and because the narrowings are around 65%, they suggest no stents to be placed, either.

For now, I am just trying to let this bit of news sink in, because I am not used to ever getting good news about FH.

I hope everyone is healthy and having a good beginning of summer.