Nov 10

Carotid Artery Update

In case you were keeping track, I’ve been getting a CIMT twice a year since starting in ’16. I just got my fourth one yesterday and was certainly curious to see what would come back.

Early on in my cholesterol education I came across an article by Rakesh C. Patel, Does LDL-P Matter?. He had this to say about the test:

My workhorse disease detection is Carotid Intima Media Thickness (CIMT). This test simply put, measures the “lining” of the carotid artery via ultrasound. The thicker the lining is, the greater the risk. It is also a way to assess for plaque (atherosclerosis) of the artery. Having plaque means you have atherosclerosis. I believe it is a significantly better way of looking at risk because we are looking for the actual pathology (1,2).

Given the last two times my thickness decreased on both sides, I figured I’d probably plateau or increase at least a little by this point.

Nope. Looks like the streak is continuing so far…

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23 Comments on "Carotid Artery Update"

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Bob Niland
Have you done a baseline and any follow-up CT calcium scans? In the program I contribute on, CIMT is considered useful and convenient, if only because you can get it run as often as you like, and cheaply, but the dispositive test is the CT calcium scan, or CAC (coronary arterial calcium), yielding an Agatston calcium score. It is radiation, so doing it more often than annually is not encouraged. Malik, Zhao & Budoff just yesterday published another paper on the utility of it. Available without doctor’s order for $100 in many places. And as with CIMT, it is possible… Read more »
I think density-volume information is likely to be a better indicator of risk than the simple Agatston. My test was read by Dr. Budoff but unfortunately he only gave me the Agatston number and I have been unable to get the full information. The density relates to plaque stability and apparently increase with the amount of exercise. Since I swim regularly and have a fairly high Agatston I would like to see the alternative calculation but it will have to wait until my next assessment. Coronary Artery Calcium Volume and Density: Potential Interactions and Overall Predictive Value: The Multi-Ethnic Study… Read more »
Karen Parrott
This is awesome, Dave, thanks for sharing. I had my CAC run via my docs order (zero calcium score btw) and I told the radiology dept tech I knew I needed a CIMT to look for soft plaque. That the CAC would only pick up hard plaque Doc refused to order one, so I’ll be hitting up a CA licensed doc ( I can use my flexible spending card), or just find a place and pay out of pocket (easier) and getting a CIMT. My latest Feldman attempt (3 days, high fat before my work insurance draw) didn’t give me… Read more »
sp salerno

Hi Dave,

Have you kept track of your fasting insulin/blood glucose/HOMA-IR since starting this?

Could be yet another example of its all about insulin…


Abhishek Anand

Have you done a CT angiogram? My cardiologist said that unlike CAC, this test uses a dye and can detect soft plaques.
In young people, non-calcified plaque may be more prevalent:

Madaj, Paul M., Matthew J. Budoff, Dong Li, John A. Tayek, Ronald P. Karlsberg, and Harold L. Karpman. “Identification of Noncalcified Plaque in Young Persons with Diabetes.” Academic Radiology 19, no. 7 (July 2012): 889–93. https://doi.org/10.1016/j.acra.2012.03.013.

My calcium score was 0. Yet, I had a 99% blockage in my LAD. My symptoms (chest pain during exercise) appeared first last month, 5 months after being on LCHF.


Interesting to see how the right has a greater improvement to almost align with the left. Will be interesting to see what the next test reveals…

Abhishek Anand

Have you come across any study evaluating how well CIMT can predict the presence/severity of lesions observed using CT Angiogram?