Left Carotid Artery 85% Blockage

@heaviside

Thank you for posting your experience. It confirms what I had read on line that I had wondered about if it was correct which was exactly what you experienced - the development of collateral circulation even if one has completed blockage of one of their carotid arteries. It's encouraging to know that even with complete blockage of one of the carotid arteries it doesn't necessarily mean you will have stroke, although I don't know how rare it is for someone to have a complete blockage of one of the arteries and remain asymptomatic.

I am an 82 year old male.

If it is of any comfort, on February 12, 2025 I had an episode of amaurosis fugax (blindness in right eye), which resolved itself with total vision recover in a few hours.

Subsequent tests showed that I had a completely occluded right internal carotid artery, and that I had had a "silent" stroke sometime in the past, that I did not notice at the time and that evidently caused little damage in the places that matter.

There was no surgery recommended because of the total occlusion. I am currently on a low dose of aspirin, and a high dose of statins.

This is now the end of October 2025, I see NO physical effects associated with my blocked carotid artery. With the permission of my doctors, I exercise daily (and have done so for many years), getting my heart rate up over 110 bpm, and am totally asymptomatic while I am doing that.

I am told this is because of collateral circulation, the body's natural backup system, consisting of a network of smaller blood vessels that can provide alternative routes for blood flow when a main artery is blocked.

The main alternate pathway for blood flow to the brain is the Circle of Willis, a ring of connected arteries at the base of the brain. This anatomical feature, combined with a network of smaller vessels, can help protect the brain from damage if one of the major arteries becomes blocked.

This alternate pathway probably became gradually more enhanced as the blockage in my right carotid artery increased over the years.

So God bless my Circle of Willis, as far as I can see the collateral circulation it provides is as good as I had before (based on decades of previous aerobic exercise that was asymptomatic), despite the fact of the total occlusion of the right carotid artery.

So even if your blockage progresses beyond 70%, it is still not clear that surgery is the best choice. That is not a choice in my case, because it is total, but the body can provide other pathways.

John Belcher

@heaviside
Hello friends,
I am 70. Here I have a case of 80% blockage in one internal carotid artery and 60% in another. The first neurologist said I must immediately go for open surgery ie ICA carotid endarterectomy. I am asymptomatic, and when I referred to this research paper 'Asymptomatic Carotid Stenosis
Identifying Patients at High Enough Risk to Warrant Endarterectomy
or Stenting' by J. David Spence, MD, FRCPC; David Pelz, MD, FRCPC; Frank J. Veith, MD, FACS, this is what I read there: "This widespread application of CAS (carotid stenting) and CEA (carotid endarterectomy) to treat ACS (asymptomatic carotid stenosys) is at best misguided and at worst unjustified. "

I went to a second neurologist, he said the guidelines for treating 'Asymptomatic carotid stenosis' till recently was through medication and life style changes. (like stop smoking, diet, exercise). However he asked to get a test for checking stability of the plaque. I got two tests done: High Sensitivity CRP and Lp-PLA2 - both indicated low risk.

I have quit smoking, following diet rich in vegetables and fruits, walking and being active through day and resting well at night. My lipid profile has improved.

I am taking the blood thinners the doctor prescribed, he had also prescribed Atorvastatin 40mg, but that gave me severe muscle cramps in 4 days. Trying to keep the LDL cholesterol low through lifestyle.

Keerthi