When plaque builds up in arteries how does it get removed?
In: Biology
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Plaques are formed from fats, cholesterol and other substances, these can be deposited for easy pick up when not needed elsewhere, as need increases and diet surplus reduces plaques are removed.
An atherectomy is the name of the procedure for removing plaque in your arteries. It involves inserting a long catheter through an artery in your groin and guiding it through to the spot of the blockage. Sometimes, we can even push dye in through the catheter, which we can see through a separate screen as it travels through the body. The dye shows us where the blockage is!
We can then remove the plaque through the same catheter, where there will be a either a sharp blade or laser to break down the plaque buildup.
It doesn’t get removed. It stays in there until it’s either surgically removed like /u/Background-Grab-8352 described or it gets dislodged and causes a clog somewhere downstream.
It doesn’t.
Atherosclerosis is a progressive disease, moves one direction. Plaques grow over time.
Now, the most dangerous plaques are unstable ones. Plaques that are inflamed and which can rupture causing a thrombosis which causes a clot which gets lodged in a narrowing. Plaques can stabilize, get calcified over time. And so, say if someone has built up plaques, but then goes on some LDL lowering medications, then the existing plaques could become stable such that they no longer present much of a threat. You can actually have a substantial narrowing of an artery but not be at risk if you don’t throw large clots off.
When someone has a complete blockage (if to the heart, a heart attack, if to the brain a stroke) the plaque can be stented – opened up with a balloon inserted through, a catheter, and then held open with a small wire stent that keeps the opening from closing up once the balloon is removed. Eventually the wire gets coated with lining of the artery. The plaque itself does not go away – it just got shoved open and pushed aside to allow the blood to flow again.
There is possibly some evidence that extreme lowering of LDL can result in regression of plaques. But we’re in early days having such medications (PCSK9 inhibitors mostly) that can lower LDL this dramatically. It may be years before we get definitive proof that such regression happens.
Plaque (also known as atheroma) is most important, and causes most trouble when it builds up in the small arteries supplying the heart. This is most important because it is the main cause of heart attacks, which are one of the biggest killers of people. Several studies have shown that sometimes plaques in the arteries in the heart can shrink or even disappear. This is not very well known, but is true. That’s very important, because as we get better treatments, we should be able to make these plaques go away before they cause trouble.
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