Sorry I haven't been on here that much as the soap opera that was my life for a few months has ended and I can move on.
I still haven't figured out how to get from the forums to the groups, if someone could PM me that I'd appreciate it.
Pops, nicely done.
I think most of what you have in there is very accurate.
As far as surgical intervention I haven't researched it recently, but I have used the numbers of asymptomatic >70% and symptomatic as a rule >60%, but I have seen interventionalist go lower. That seems to be the standard here in my neck of the woods.
You mentioned the metabolic syndrome. The insulin is the biggest problem with this for the majority of people, and I'm pretty sure I got on my soap box in another post so I won't go into that her except to say that while we need the insulin to move the sugar into our cells, it is lipogenic (fat generating) and causes inflammation.
You also mentioned the plaques and the "blood clots" What actually happens here is the venturi effect (for those of old enough to remember carburetors this is how they work also) As an area of the blood vessel gets smaller and smaller due to the plaque (which is caused by deposited cholesterol and oxidation/inflammation), the same volume of blood has to try to get thru there and so the velocity (speed) of the blood flow increases. As that speed increases so does the force that hits the leading edge of that plaque. At some point the plaque breaks open from the stress and exposes a "raw area". Then just like if you cut yourself, the body activates it's clotting mechanisms, and poof a clot is born. These can either be bad enough to stop the flow right there or break off and move downstream into smaller blood vessels until they get stuck and clog the plumbing.
So, as much as I hate statin medications they do lower the cholesterol and they do stabilize these plaques. The other "blood thinners" that Pops mentioned actually don't thin the blood, they just make things less "sticky" in an effort to prevent that clot from forming.
As far as the Tpa, this actually can dissolve a clot, but like Pops noted there is a VERY limited time window on this; 3 hours from the onset of symptoms. That means you have to get to the hospital, be evaluated, have a CT scan of your brain and get the Tpa in this time period. Do not dilly-dally here, if you have the symptoms get to the hospital!
Hope this helps.