GCA culprit with possible plaque in artery

[luv2read]

Has anybody had stents put in with GCA being the main culprit? I went for a scan and got the results and I can't find anything that means it's good or bad. My appointment with the vascular surgeon is tomorrow and was wondering if anyone on here can tell me if my distal external iliac artery is high? Left is 250 cm/sec and right is 343 cm/sec. I had a stent put in about 1 1/2 years ago and was told that this could be due to my GSA and prednisone use. I wish I knew what the numbers mean, before going into the appointment tomorrow so I can feel better prepared. I have a feeling they are extremely high, but it's hard for me to decipher all the medical lingo on Google. Any answers or suggestions on where else to look would be appreciated soooo much!

[PMRpro Ambassador]

Is this just a routine check or are you having problems?

I might be wrong, but I suspect it isn't the absolute figures that are important - it is the comparable speeds in the two arms of the artery

onlinelibrary.wiley.com/doi...

is a really complex modelling paper but they are talking about how atherosclerotic plaques change the blood flow patterns. It is a bit like a river that divides so the water goes down 2 sides of an island - the flow patterns will depend on the stones, debris, angles of the shore and the flow patterns determine the speed the water is moving at and causing turbulence which can erode the sides and cause things to detach. The pictures show the places you get deposits.

I think your results are showing that there are very different flow speeds in the two sides which suggests there might be some disturbed flow which can be what makes plaque unstable and cause a clot to detach - and a bit of clot floating around the body and getting caught in a narrow bit is what leads to stroke, heart attack or pulmonary embolism, They use the stents to stablise the sides of the artery.

[pegpowell]

Have been reading about PMR/GCA for years but don't recall reading about the connection with PAD (peripheral arterial disease) and steroid use. Since discovering that I have PAD and carotid artery blockage this year, I have discovered research that states 5 year use of steroids can cause PAD in the PMR community. I would be interested in hearing how others have coped with this disease. Fortunately, medications have so far allowed me to avoid stents or other surgery. I am hoping that I will be able to have my ailing hip replaced and will find out next week. I will soon be in my sixth year of prednisone and have had several steroid shots in my knees, hip, shoulder. I started with 15 mgs pred and am now at 4 mgs.

[PMRpro Ambassador in reply to pegpowell]

I have been on pred for over 12 years - no sign of PAD at all. PMR and GCA are also risk factors because the inflammation is thought to cause damage to the lining of the arteries and longterm that then may lead to atherosclerosis

[luv2read in reply to PMRpro]

PMRpro,

Thank you for your explanation. I loved how you compared it to a river. So spot on. I responded to pegpowell with my results on my appointment this morning. i'll let you go ahead and read my response instead of repeating my self.

I read the posts everyday. I am certainly no professional so I rarely share anything, but I learn so much from the repsponses.

I also want to thank you for taking the time to respond to me. I can always count on you for honest answers. You probably don't realize how much you help all of us on this forum. Again, I can't thank you enough!

[luv2read in reply to pegpowell]

After having my appointment this morning, I understand that it's more likely hereditary, but he has seen some patients with GCA that developed PAD after the onset. Maybe coincidence, maybe not??? Anyways, my arteries are clear, so that is the main thing. I did have stents put in, back in 2018 after being diagnosed with Giant Cell. My left leg had to be done again in 2020! At least now, things look good for me.

On another note, he said, "You're still on prednisone?" I started at 65 mg in 2018, and I am now down to 4 mgs. I know that's between my rheumy and myself, but he, (my rheumy), has told me several times that I will never be off of it. He starts telling me about studies and such, every time I ask. I love him as a doctor. He has been so good to me, especially during the dark days of my diagnosis. He is the most thorough doctor I have ever seen. It drives me crazy sometimes, but i trust him. I will wean HIM off of me getting off of the prednisone slowly!!! LOL

Good luck with you and your hip!

[PMRpro Ambassador in reply to luv2read]

He sounds a keeper. There is an established increase in PAD in GCA patients.

[cycli in reply to PMRpro]

cheers for that good news PMR pro. Don't you just love this disease. I'm beginning to doubt if I'll ever be able to put the same load on my vascular system that I used to especially when doing my long 5 to 10 mile continuous cycling up mountain roads. Even if I manage to rebuild the muscle strength and stamina it's looking like systemic irregularity and weakening of the vessels which carry the fuel to them is going to be the decider. Happy days, and I'm only just starting the trip. Still, I've got to try. What other course is there.

[Bcol in reply to cycli]

Morning Cycli, you also have to remember that we are also getting older, can't do much about that, so that even when ( being positive here) we get to the end of this disease/s natural ageing will be having its normal effect on not allowing us to do what we used to so it won't necessarily all be down to our ailments and medication.

[cycli in reply to Bcol]

morning Bcol. I know all too well sadly. But remember I was cycling with 35 to 40 year old club members for 6 continuous days over this terrain when 68 years old and I wasn't the slowest or last person up the climbs. So while I am getting older I am starting from a very real perception of what I should be able to achieve. Realistically that previous level won't be possible if ever again. It's what level I can attain and this issue could seriously affect my ability to do the necessary exercise to build the muscle. If so then that's it but one has to try. Whichever way I cut it I can't see major improvements happening quickly and I'm going to be that much older. Still, it will be an interesting experiment.