ORIGINAL ARTICLES   

International Angiology 1998 March;17(1):22-7

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Prevalence of morphological alterations in cervical vessels: a colour duplex ultrasonographic study in a series of 3300 subjects

Pancera P., Ribul M., De Marchi S., Arosio E., Lechi A.

From the Institute of Internal Medicine, University of Verona, and * Department of Vascular Rehabilitation, Valeggio Hospital, Verona, Italy

Background. In order to ­define the mor­pho­log­i­cal var­i­ants ­involved in carot­id elon­ga­tion in terms of their clin­i­cal impli­ca­tions, we have ana­lysed the prev­a­lence of mor­pho­log­i­cal alter­a­tions in ­patients rou­tine­ly sub­ject­ed to carot­id ­colour ­duplex ultra­so­nog­ra­phy eval­u­a­tion.
Methods. From January 1, 1993 to June 30, 1996 3300 sub­jects were exam­ined for cen­tral ner­vous ­system symp­toms (41% of cases) or for screen­ing relat­ed to ischaem­ic heart dis­ease, lower limb arte­ri­al dis­ease, hyper­ten­sion or major dys­lip­i­dae­mia (59% of cases). The χ2-test was used for sta­tis­ti­cal anal­y­sis.
Results. Morphological alter­a­tions ­increased with age. While kink­ing was more prev­a­lent in ­females (female:male ratio 58% vs 42%), sharp kink­ing was sig­nif­i­cant­ly more fre­quent in males (39% vs 15%, p<0.001). Atheromatous ­plaques pre­dom­i­nat­ed in males (79% vs 46%, p<0.001), as well as cases with hae­mod­y­nam­i­cal­ly sig­nif­i­cant involve­ment (16% vs 7%, p<0.001). In ­patients with kink­ing there was a prev­a­lence of hae­mod­y­nam­i­cal­ly sig­nif­i­cant ­lesions (χ2=52.7, p<0.001). A pos­sible link ­between con­for­ma­tion­al abnor­mal­ities and hyper­ten­sion ­appeared high­ly sig­nif­i­cant owing to a very dif­fer­ent prev­a­lence of high blood pres­sure in the group of sub­jects with kink­ing (χ2=239, p<0.001). We did not find a sig­nif­i­cant asso­ci­a­tion ­between major neu­ro­log­i­cal symp­toms and the pres­ence of kink­ing (χ2=0.215, p=0.643), but we found an asso­ci­a­tion with tran­sient ischaem­ic ­attacks (χ2=6.9, p<0.01).
Conclusions. Conformational abnor­mal­ities like kink­ing, seem much more prev­a­lent in sub­jects suf­fer­ing from arte­ri­al hyper­ten­sion. Even ­though high blood pres­sure is an impor­tant risk fac­tor for tran­sient ischaem­ic ­attacks, it is pos­sible that the prev­a­lence of ath­e­rom­a­tous ­lesions and the flow tur­bu­lence ­linked to kink­ing may also play a role in their pathoph­y­sio­lo­gy.