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FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOJOURNAL OF NEUROSURGICAL SCIENCES

Rivista di Neurochirurgia

Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651

Periodicità: Bimestrale

ISSN 0390-5616

Online ISSN 1827-1855

 

Journal of Neurosurgical Sciences 2016 Nov 17

Association between carotid artery tortuosity and carotid dissection: a case-control study

Sarasa T. KIM 1, Waleed BRINJIKJI 2, Vance T. LEHMAN 2, Carrie M. CARR 2, Patrick H. LUETMER 2, Charlotte H. RYDBERG 2

1 Mayo Clinic, Mayo Medical School, Rochester, MN, USA; 2 Mayo Clinic, Department of Radiology, Rochester, MN, USA

BACKGROUND: Carotid artery dissections have long been associated with compromise of the structural integrity of the arterial wall from heritable connective-tissue disorders, hypertension, and trauma. However, an association between spontaneous internal carotid artery dissection and tortuous or redundant carotid anatomy has not been fully explored.
METHODS: Patients with CTA confirmed spontaneous cervical internal carotid artery dissections were compared to a group of age and sex matched controls who also received CTA of the neck. Patients with trauma or aortic dissections were excluded. Five radiologists reviewed the CTA images to evaluate internal carotid artery tortuosity (reported as loops, kinks or coils), retrojugular and retropharyngeal courses of the internal carotid artery, presence of fibromuscular dysplasia and presence of atherosclerotic disease. Baseline data collected included demographic characteristics (sex, age, smoking history) and cardiovascular comorbidities.
RESULTS: A total of 83 cervical internal carotid artery dissection and their age and sex matched controls were included in this study. 46% of patients were female in each group and mean age was 49.2±10.6 years. The presence of any carotid tortuosity was 53% (n=44) and 34% (n=28) in the per-patient analysis of dissection and control groups, respectively (P=0.02). Loops were reported in 22% (n=18) of dissection patients and 8% (n=7) of controls (P=0.03). Retrojugular course of the internal carotid artery were seen in 23% (n=38) of dissection patients and 9% (n=15) of controls (P=0.0009) in the per-vessel analysis.
CONCLUSIONS: Our study suggests that there is an association between the presence of tortuous carotid artery anatomy and spontaneous carotid artery dissection. This finding emphasizes the importance of the presence of tortuous arteries on CTA imaging to increase the index of suspicion for a potential dissection.

lingua: Inglese


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