Near-Occlusion of Left Vertebral Artery & Looking For Advice

I had bypass at 55. It’s been 8 years and just had a heart cath that showed no new blockages.

From the web:
Near-occlusion of my left vertebral artery
The near-occlusion of the left vertebral artery can be a serious condition that requires immediate medical attention. It is often caused by plaque buildup or dissection and can lead to transient ischemic attacks (TIAs) or strokes if left untreated. Symptoms may include vertigo, dizziness, and double vision, which are reasons to seek medical attention. Treatment options may include aspirin, statins, and possibly other medications to prevent further narrowing and improve blood flow. It is crucial to follow the advice of healthcare professionals and undergo regular monitoring to manage this condition effectively.
Mayo Clinic

@rebaheizer
Did you have bypass surgery due to a totally occluded vertebral artery?

@lenmayo Thank you. I did Google the condition I have and found similar passages online. I'm just curious about personal experiences with this condition & how people fared. Did it always lead to a completely occluded artery? Do channels form to reroute the blood? If the right vertebral artery is clear and one remains asymtomatic, does that stabilize the condition & reduce the risk of a TIA or stroke?

Since I'm on the blood thinner, Eliquis, I cannot have aspirin, which would substantially increase my bleeding risk. Not sure what a low dose statin would do at this point...My doc is recommending Livalo and continuing with exercise daily and Med diet. Rechecking my BP to be sure I don't need meds to control it.

Am I in the right forum for this condition? My PCP is consulting with the Neurology docs & not Cardiologists...

@northrancher Possibly, probably. This is not a cardiac problem so much as a 'vascular' problem, and it happens to be located in the spine, hence your PCP going to a neurologist. You may also wish for a vascular surgeon to be involved....my opinion. Maybe not just yet, but the neurologist might wish to bring one on board to help him decide if this blockage can be bypassed at all.

@gloaming Thank you! Your reply is very helpful. Good to know a vascular surgeon may need to be involved at some point...

My PCP told me that Neurology won't get involved unless I am symptomatic, as there is nothing they can do (stenting) at this stage. That the treatment for a near-occlusion (less than 70%) is all about blood thinner, statin, controlling blood pressure, diet, exercise.

Crossing my fingers it's all enough to prevent the near occlusion from becoming a full occlusion.

Hi, im responding because we have similar circumstances. I am 44 and have a full occlusion in my left vertebral artery and I have had a stroke. I however am symptomatic. I have had my blood clot for almost 2.5 years. I went to my neuro doctor last Friday and he told me NO more eliquis. He said just aspirin and statin. He said the blood clot is staying put. They will absolutely not remove it because risk of it breaking off and traveling to smaller arteries in the brain and I have a high risk of brain bleed which can be fatal if the blood flow is restored. None of my doctors gave a prognosis of when or if I will have another stroke soon. My stroke happened almost 2.5 years ago. I thought that I had a dissection but, my doctors think it's from plaque. I think that it may have been a dissection given that the other vertebral artery right next to it is in perfect health and there are no abnormalities in the opposite artery. Also, I am very young to have what I've been told is extremely bad artery disease. My cholesterol levels at the time of my stroke were normal. Anyway, I guess I was told not to take eliquis mainly because of the risk of the blood clot dissolving and the risk of brain bleed if blood flow is restored to my brain because the brain has since adapted to the low flow of blood. I was explained that the brain tissue is not healthy anymore and would not be able to tolerate this sudden change.

@schmidt1981 I'm so sorry to hear what you're going through, especially at your young age. I'm curious about why you were taking Eliquis? How did they determine you had a stroke 2.5 years ago? Was that just dx recently or when the stroke happened? Surprising that your cholesterol numbers were normal when you had the stroke. Sounds like you're getting really good medical care and I hope your med regimen keeps you stable long into the future.
Since I posted, I've been seen by a neuro/vascular doc. I had a brain MRI, which confirmed no abnormalities or strokes. In my case, the neuro doc said my vertebral artery has formed collateral blood flow around the blockage, which is robust. That's why I have no symptoms. I was told to keep taking Eliquis and a statin. Had I not been on Eliquis, I would've been on an aspirin + statin, just like you. If the MRI had shown evidence of a stroke, the neuro doc would've added Plavix. I'm just guessing they are keeping me on Eliquis to maintain the status quo, since my blood flow is not an issue & no abnormalities (clots, strokes) were found. But, I will ask my doc about it, so thank you for sharing that! I realize that every case is different. My stroke risk is still greater than someone who doesn't have a near-blocked artery, so I need to be on alert for any symptoms.
How often are you monitored? And, do you get an MRI, CT scan, sonogram?
I so appreciate your reply and sharing your experience. Wishing you all the best!