Spontaneous and Endothelial-Independent Vasodilation Are Impaired in Patients With Spontaneous Carotid Dissection

Abstract

Background and Purpose-We undertook this case-control study in patients with unilateral spontaneous dissection of the cervical internal carotid artery to investigate spontaneous and endothelium-independent dilation of the nondissected, contralateral carotid arteries and the ipsilateral brachial artery using high-resolution ultrasound. Methods-Spontaneous and endothelial-independent (nitroglycerin-mediated) absolute and relative dilation were assessed in the internal and common carotid and brachial arteries of 27 patients with unilateral spontaneous dissection of the cervical internal carotid artery and 27 age-and sex-matched healthy controls. Results-Absolute and relative spontaneous and endothelial-independent dilation of the carotid, but not brachial arteries, were significantly lower in patients as compared with controls. Conclusions-Vasodilation

Wall stress of the cervical carotid artery in patients with carotid dissection: a case-control study

“…The increase of carotid sinus length during the first 45°of head rotation was 90% in controls but only 60% in patients. This difference is in accordance with the findings of case-control studies that have shown that carotid artery dilation is reduced in patients with sICAD (3,6). The lack of significance between the two groups in the present study (P Ͼ 0.48) may be related to the low number of the 10 investigated subjects.…”

“…Patients with sICAD have a higher prevalence of hereditary connective tissue disorders such as Marfan syndrome, Ehlers Danlos syndrome, osteogenesis imperfecta, and, in particular, fibromuscular dysplasia (2,16,17,31,35,(37)(38)(39). In addition, several case-control studies have shown that vasomotion is impaired in patients with sICAD (3,6). Despite this, we have assumed constant material properties along the carotid arteries of patients and controls.…”

Current Optimal Assessment and Management of Carotid and Vertebral Spontaneous and Traumatic Dissection

“…15,16 In addition, both endothelium-dependent and endotheliumindependent vasodilatation was found to be impaired in patients with SD. 17,18 Several studies have failed to demonstrate any association between various connective tissue disorder genes and SD, and there is some evidence that the apolipoprotein E (e4 allele), which is associated with to premature atherosclerosis, may further protect against SD. 9,19 Spontaneous dissections have been linked to a proinflammatory predisposition with polymorphism of the intercellular adhesion molecule 1 with a 3-fold increased risk of SD, indicating a possible role for an abnormal inflammatory response.…”

Cervical Carotid Artery Dissection

“…[47][48][49][50] During conventional angiography, between 12% and 18% of patients with carotid dissections are found to have changes consistent with fibromuscular dysplasia. [53][54][55][56] Heritable connective tissue disorders have been associated with an increased risk of spontaneous dissection. [53][54][55][56] Heritable connective tissue disorders have been associated with an increased risk of spontaneous dissection.…”