Association between internal carotid artery dissection and arterial tortuosity

Saba, Luca; Argiolas, Giovanni Maria; Sumer, Suna; Siotto, Paolo; Raz, Eytan; Sanfilippo, Roberto; Montisci, Roberto; Piga, M.; Wintermark, Max

doi:10.1007/s00234-014-1436-x

Cited by 54 publications

(41 citation statements)

References 24 publications

(25 reference statements)

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“…Nevertheless, this may have been underestimated because of diagnostic challenges with ultrasound acquisition and interpretation. The prevalence is higher with computed tomography and magnetic resonance imaging [10]. However, there have been an increasing number of reports of McICA in recent years.…”

Section: Discussionmentioning

confidence: 99%

Morphological changes of the internal carotid artery: prevalence and characteristics. A clinical and ultrasonographic study in a series of 19 804 patients over 25 years old

Martins¹,

Mayer

Batista

et al. 2017

Euro J of Neurology

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Background and purpose: Morphological changes of the internal carotid arteries (McICA) are frequently found during cervical ultrasound studies. However, the etiology of McICA remains controversial. During this study, the prevalence and demographic characteristics of McICA, such as kinking, coiling or looping identified by Doppler ultrasound, were analysed and its relationship with vascular risk factors and stroke was assessed. Methods: A retrospective study was performed by analysing 19 804 patients who were subjected to cervical ultrasonographic study between January 2000 and June 2012. The data were statistically analysed with SPSS Ò 20 and a multivariate logistic regression was performed. Statistical significance was accepted for P < 0.05 and 95% confidence intervals (CIs) were used.Results: Morphological changes of the internal carotid arteries were present in 2678 patients (13.5%) and were unilateral in 61.6% of these cases. Carotid kinking was found in 80% of the patients, coiling in 16% and looping in 1%. In multivariate analysis, the presence of McICA was related to older groups (1.04; 95% CI, 1.04-1.05; P < 0.01), female gender (1.78; 95% CI, 1.64-1.94; P < 0.01), patients with hyperlipidemia (1.28; 95% CI, 1.17-1.40; P < 0.01), carotid thickness (1.22; 95% CI, 1.13-1.33; P < 0.01) and cardiac or cardioembolic disease (1.11; 95% CI, 1.01-1.21; P = 0.02). The results of this study indicate that kinking in the carotid artery was associated with ipsilateral cerebral ischemic events (1.43; 95% CI, 1.040-1.958; P < 0.05). Conclusion: Morphological changes of the internal carotid arteries were associated with aging, female gender and patients with hyperlipidemia, hypertension, diabetes and heart disease. Kinking was associated with ipsilateral cerebral ischemia.

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Section: Discussionmentioning

confidence: 99%

Morphological changes of the internal carotid artery: prevalence and characteristics. A clinical and ultrasonographic study in a series of 19 804 patients over 25 years old

Martins¹,

Mayer

Batista

et al. 2017

Euro J of Neurology

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“…The presence of carotid elongation has been associated with dissections [6,16] . Our findings corroborate the notion that elongation (specifically S-curve) is independently associated with dissection.…”

Section: Discussionmentioning

confidence: 99%

Internal Carotid Artery S-Shaped Curve as a Marker of Fibromuscular Dysplasia in Dissection-Related Acute Ischemic Stroke

Haussen¹,

Jadhav²,

Rebello³

et al. 2016

Intervent Neurol

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Background and Purpose: Craniocervical fibromuscular dysplasia (FMD) is associated with dissections and with S-shaped curves in the internal carotid artery (ICA). We evaluated the occurrence of S-curves in patients presenting with acute strokes due to ICA steno-occlusive dissections. Methods: This was a retrospective review of the interventional databases of two academic tertiary-care institutions. The presence of ICA S-shaped curves, C-shaped curves, 360-degree loops, as well as classic FMD and atherosclerotic changes at the ICA bulb and curve/loop was determined. Cases of carotid dissections were compared with a control group (consecutive non-tandem anterior circulation strokes). Results: Twenty-four patients with carotid dissections were compared to 92 controls. Baseline characteristics and procedural variables were similar, with the exception of younger age, less frequent history of hypertension, diabetes, atrial fibrillation and stent retriever use in patients with dissections. The rates of mTICI2b-3 reperfusion, parenchymal hematoma, good outcome and mortality were similar amongst groups. The frequency of S-curves (any side without superimposed atherosclerosis) was 29% in the dissection group versus 7% in controls (p < 0.01). S-curves were typically mirror images within the dissection group (85% had bilateral occurrence). The frequency of C-shaped and 360-degree curves was similar between groups. FMD changes within the craniocervical arteries were statistically more common in dissection patients. Ten patients (41%) of the dissection group had S-curves or classic FMD changes. Multivariate analysis indicated that S-curves were independently associated with the presence of dissections. Conclusion: S-shaped ICA curves are predictably bilateral, highly associated with carotid dissections in patients with moderate to severe strokes, and may suggest an underlying presence of FMD.

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“…Headaches are variable and range from minor and nondescript to thunderclap headaches mimicking subarachnoid hemorrhage (SAH). Oculosympathetic palsy, cranial neuropathy including trigeminal (V), facial (VII), glossopharyngeal (IX), vagal (X), spinal accessory (XI) and hypoglossal nerves (XII), and pulsatile Osteogenesis imperfecta-type I [5,7] Aorta coarctation a1-Antitrypsin deficiency [12] Chiropractic cervical manipulation [8] 677TT genotype of the 5,10-MTHFR [13] Iatrogenic after surgical interventions Down syndrome [14] Styloid process length (Eagle syndrome) [15] Moyamoya disease [16] Vascular tortuosity [17] Cystic medial degeneration [6] Polycystic kidney disease [8,9 && ] ICAM-1 E4690 K gene polymorphism [18] ICAM-1, intracellular adhesion molecule-1; MTHFR, methylenetetrahydrofolate reductase.…”

Section: Internal Carotid Artery Dissectionmentioning

confidence: 99%

“…Gadolinium has been associated with nephrogenic systemic fibrosis in patients with severe renal impairment and patients undergoing dialysis because of poor clearance and deposition in dermatologic tissue. MRI and MRA are contraindicated in patients with ferromagnetic intracranial clips or coils, metallic foreign bodies such as bullets and shrapnel, ferromagnetic vena cava filters, pulmonary artery catheters, temporary transvenous pacing leads, intraaortic balloon pumps, left ventricular assist devices, implantable cardioverter-defibrillators, cardiac pacemakers, cochlear implants and neurostimulation systems [16,21].…”

Section: Computed Tomography Angiography and Magnetic Resonance Angiomentioning

confidence: 99%

Cervicocerebral artery dissection

Ortiz

Ruland

2015

Current Opinion in Cardiology

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Association between internal carotid artery dissection and arterial tortuosity

Abstract: The presence of kinking and coiling is associated with ICAD.

Cited by 54 publications

References 24 publications

Morphological changes of the internal carotid artery: prevalence and characteristics. A clinical and ultrasonographic study in a series of 19 804 patients over 25 years old

Morphological changes of the internal carotid artery: prevalence and characteristics. A clinical and ultrasonographic study in a series of 19 804 patients over 25 years old

Internal Carotid Artery S-Shaped Curve as a Marker of Fibromuscular Dysplasia in Dissection-Related Acute Ischemic Stroke

Cervicocerebral artery dissection

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