Carotid Artery Anatomy and Geometry as Risk Factors for Carotid Atherosclerotic Disease
- 1 June 2012
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 43 (6), 1596-1601
- https://doi.org/10.1161/strokeaha.111.645499
Abstract
Background and Purpose— Traditional vascular risk factors do not completely explain the asymmetry, racial, and sex differences in carotid artery disease. Carotid anatomy and geometry may play a role in the pathogenesis of internal carotid artery (ICA) stenosis, but their effects are unknown. We hypothesized that carotid artery anatomy and geometry would be independently associated with ICA stenosis. Method— This is a retrospective study of patients with CT angiography at Monash Medical Centre, 2006 to 2007. Carotid arteries were segmented using semiautomated methods to estimate measures of carotid anatomy and geometry. Measurements of carotid artery geometry were performed according to the recent article by Thomas and colleagues. ICA stenosis was dichotomized as <30% or ≥30% stenosis. Cluster logistic regression was used to examine the associations of anatomy and geometry with stenosis accounting for the paired arteries within subjects, adjusting for age, sex, and vascular risk factors. Results— Mean age of the sample (n=178) was 68.4 years (SD, 14 years). The following were independently associated with ICA stenosis: ICA radius at the bifurcation (OR, 0.20; 95% CI, 0.14–0.29), ICA angle (OR, 1.05 per degree increment; 95% CI, 1.04–1.07), age (OR, 1.05 per year increment; 95% CI, 1.03–1.07), male sex (OR, 1.72; 95% CI, 1.08–2.8), and ever-smoker (OR, 1.85; 95% CI, 1.15–2.96). Conclusions— Carotid anatomy and geometry may enhance the risk of stenosis independent of traditional vascular risk factors and may be of help in very early identification of patients at high risk of developing carotid artery atherosclerosis for aggressive intervention.Keywords
This publication has 18 references indexed in Scilit:
- Does the principle of minimum work apply at the carotid bifurcation: a retrospective cohort studyBMC Medical Imaging, 2011
- In Vivo Wall Shear Stress Distribution in the Carotid ArteryCirculation: Cardiovascular Imaging, 2010
- Geometry of the Carotid Bifurcation Predicts Its Exposure to Disturbed FlowStroke, 2008
- Variation in the Carotid Bifurcation Geometry of Young Versus Older AdultsStroke, 2005
- Internal Carotid Artery Angle of OriginStroke, 2003
- Clinical alert: benefit of carotid endarterectomy for patients with high-grade stenosis of the internal carotid artery. National Institute of Neurological Disorders and Stroke Stroke and Trauma Division. North American Symptomatic Carotid Endarterectomy Trial (NASCET) investigators.Stroke, 1991
- Geometric factors of the bifurcation in carotid atherogenesis.Stroke, 1990
- Compensatory Enlargement of Human Atherosclerotic Coronary ArteriesThe New England Journal of Medicine, 1987
- A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for HeteroskedasticityEconometrica, 1980
- SIGNIFICANCE OF THE RELATIVELY LOW INCIDENCE OF ATHEROSCLEROSIS IN THE PULMONARY, RENAL, AND MESENTERIC ARTERIES*Annals of the New York Academy of Sciences, 1968