Can Atherosclerotic Plaques Be Eliminated?

Atherosclerotic plaques, which develop through processes such as smooth muscle cell proliferation, migration, and fibrosis, eventually become integrated into the arterial wall and cannot be completely removed. However, with the help of medication—especially drugs that lower low-density lipoprotein (LDL) cholesterol—these plaques can be effectively managed. In some patients, partial regression of plaque buildup may occur, leading to a reduction in plaque size. Currently, however, no technology exists to fully eliminate atherosclerotic plaques.

Understanding the Formation of Atherosclerotic Plaques

The development of atherosclerotic plaques is a complex biological process. It typically begins with damage to the endothelial lining of the blood vessel. Once the endothelium is injured, LDL cholesterol particles can penetrate into the vessel wall and accumulate within the intima. These cholesterol particles undergo oxidation, triggering an inflammatory response.

Macrophages in the vessel wall then engulf the oxidized LDL cholesterol, transforming into what are known as foam cells. These cells contribute to the accumulation of fatty deposits and further promote inflammation, which plays a central role in the progression of atherosclerosis.

Treatment Strategies for Managing Plaque Buildup

Statin Therapy: The First Line of Defense

One of the most effective strategies for managing atherosclerotic plaque involves the use of statins—cholesterol-lowering medications that inhibit the liver enzyme responsible for cholesterol production. Since cholesterol deposition is a key driver in plaque formation, reducing LDL cholesterol levels can significantly slow plaque progression and, in some cases, promote plaque regression.

Combination Therapy for Enhanced LDL Control

If statin therapy alone does not lower LDL cholesterol to the desired target levels, additional medications such as ezetimibe—a cholesterol absorption inhibitor—can be introduced. Ezetimibe works by reducing the amount of cholesterol absorbed from the diet, thereby further lowering circulating LDL levels. Combining different classes of lipid-lowering drugs allows for more comprehensive management of cholesterol and can enhance the overall effectiveness of treatment.