re: OT Med Folks--My Docs are Stumped

I didn't read through the whole thread but it does sound like an interesting case. Just to clarify some of your story: it sounds like you had a bruit (whooshing pulsatile sound heard with a stethoscope) on the right of your neck which was found to be a blockage in your carotid. You had an endarterectomy which showed not - typical plaque but rather signs of inflammatory thickening of the arterial wall causing the blockage. It has closed again but you are doing ok because of good collateral flow from the other carotid and the vertebral arteries.

It sounds to me like you may need a work up for possible causes of vasculitis. You are pretty young to be dealing with an atherosclerotic plaque buildup of that magnitude to cause a blockage and no chance it can restenose that quickly after surgery. There is definitely something inflammatory going on. You should be getting tests like a C reactive protein (CRP) to investigate for inflammation as well as tests for autoimmune causes of inflammation. Also your blockage was a slow developing condition given your development of collateral circulation - that only takes place over a longer period of time.

My advice is to seek further consult with a vascular surgeon specialist who has interest in inflammatory vascular disease processes. Chances are you may have to go a university type hospital for this sort of subspecialization. Good luck.

Please note the above is not competent medical advice - I could just be a 14 year old who can use google and webmd.