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CMIT / Vascular carotid screening using duplex ultrasound

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  • CMIT / Vascular carotid screening using duplex ultrasound

    Hello! I just took Dr. Brewer's "Plaque Evaluation Course" on the Prevmed web site. I have an appointment with a Cardiologist next Tuesday and would like some input on a "Vascular carotid screening" that I had at UPMC hospital. Prior to viewing Dr. Brewer's course I was not familiar with CMIT's and it appears it is different than the "vascular carotid screening using duplex ultrasound" that I had. I am a 62 year old male and had the carotid ultrasound done in November of 2018 and had 15% stenosis on left side and 0% on right side. I went a year later in November of 2019 and result was alarming as the right side showed stenosis of 25%. Here is the exact wording from the results... "The carotid screening shows CIMT bilaterally. The right side shows mild/moderate hypoechoic plaque in the internal carotid artery with 25% stenosis. This is a significant change when compared to previous. The left side shows mild/moderate heterogeneous plaque in the carotid bulb, with a 15% stenosis".
    >>My question is this... How unusual is it for the plaque to increase from zero to 25% in only one year?? Also, how much should I trust the accuracy of the ultrasound? How concerning is this??
    It clearly made me very nervous and I made many diet changes (viewing many of Dr. Ford's materials) and began to take Rosuvastatin 10mg. My cholesterol went from 250 to 160 in three months. Specifically HDL from 55 to 58; LDL 175 to 85; and triglycerides from 124 to 84; also... cardio CRP was .5 mg/L. I have always been an exercise junky and I am not overweight, but after diet changes (cut out most carbs) I went from 192lbs to 180 and I am 6'2".
    Based on info on Prevmed, I am going to request the advanced Lipids test along with some of the other inflammation markers. I also plan to request the CTA and CACS to be completed. I am also looking at the PRevmed schedule of events so I can have the CMIT completed and I plan on taking the Prevemed courses for Insulin resistance and Cardiovascular inflammation.
    I know a lot of info... any thoughts are appreciated, but my real questions were above.>>
    Thanks in Advance!!
    Frank

  • #2
    You are clearly doing good work. Given what I see, it sounds like you may have a carb problem that you’ve improved significantly. Keep up the good work. I’d consider clarifying. OGTT, insukin survey, CGM/Libre, fingerstick etc. call Cliede or Michelle if you’d like our help - 859-721-1414

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    • #3
      Below is an excerpt that I think might answer your questions in a way as it is difficult to be certain given only the one testing method. As Dr. Brewer said, you seem to understand what is going on pretty well and are on the right path.

      "Carotid ultrasonography is a good way to evaluate severe carotid stenosis, but it's less accurate for milder blockages. Reliable results depend on good equipment, an experienced technician, and a skilled interpreter, but even with all three, patients who are being considered for surgery or angioplasty should have more detailed imaging studies."

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      • #4
        Thanks a bunch for the feeback and info! After my appointment with my UPMC cardiologist next week I will contact Cliede or Michelle. Thanks again!

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