Association Between Abnormal Course of Carotid Artery and Cerebrovascular Disease
Yi-Sin Wong1, Cheung-Ter Ong2, Sheng-Feng Sung2
1Department of of Family Medicine, Chia-Yi Christian Hospital, Chia-Yi, Taiwan ROC.
Insights
Abnormal carotid artery course (ABCA) is more common in women and older individuals but does not correlate with stroke or its risk factors. Patients with ABCA require observation unless neurological symptoms arise.
Area of Science:
- Vascular Medicine
- Neurology
- Medical Imaging
Background:
- Abnormal course of the carotid artery (ABCA) is frequently detected during carotid sonography.
- The association between ABCA, stroke, and stroke risk factors remains incompletely understood.
Purpose of the Study:
- To determine the prevalence of ABCA.
- To investigate the relationship between ABCA and stroke, as well as common stroke risk factors.
Main Methods:
- Color duplex ultrasound of carotid arteries was performed on 615 subjects.
- Data collected included ABCA presence, intimal thickness, and stroke risk factors (hypertension, diabetes, dyslipidemia, atherosclerosis, stroke history, heart disease).
- Statistical analysis evaluated the prevalence of ABCA and its association with stroke and risk factors.
Main Results:
- ABCA was identified in 4.1% of subjects, with a higher prevalence in women (6.3%) than men (1.9%) and in individuals over 65 years old.
- No significant difference in ABCA prevalence was observed between stroke and non-stroke patients.
- Logistic regression did not reveal associations between ABCA and hypertension, diabetes, dyslipidemia, stroke history, heart disease, or atherosclerosis.
Conclusions:
- The prevalence of ABCA in this study was lower than reported previously.
- ABCA is more common in women and older patients but is not associated with stroke or its risk factors.
- Observation is recommended for patients with ABCA unless neurological symptoms are present.
Purpose:
Abnormal course of the carotid artery (ABCA) is commonly identified during carotid sonography studies. Whether ABCA is related to the risk of stroke and stroke risk factors remains unclear. The purpose of the study is to investigate the prevalence of ABCA and the relationship with stroke and the risk factors of stroke.
Methods:
Color duplex ultrasound scanning of carotid arteries was performed on 615 subjects (between January 1, 2012 and March 31, 2012). ABCA and intimal thickness were recorded. Risk factors of stroke such as hypertension, diabetes mellitus, dyslipidemia, atherosclerosis, stroke history, and heart disease were recorded. The prevalence of ABCA was analyzed and its relationship with stroke and stroke risk factors was evaluated.
Results:
ABCA was found in 4.1% (25/615) patients, 6.29% (19/302) in women, and 1.91% (6/313) in men. ABCA in 1 vessel was noted in 18 patients, 2 vessels in 3 patients, 3 vessels in 3 patients, and 4 vessels in 1 patient. The frequency of ABCA was significantly higher in women than in men (6.3% vs 1.9%, p = 0.01). There was no difference in the prevalence of ABCA between stroke patients and nonstroke subjects ( p = 0.60). ABCA was more frequent in patients older than 65 years. (5.91% (22/372) vs. 1.23% (3/243) p = 0.01). Logistic regression analysis did not reveal associations between ABCA and stroke risk factors (hypertension, diabetes mellitus, dyslipidemia, stroke history, heart disease and atherosclerosis). During 1 year follow-up, 2.88% (17/590) of non-ABCA patients and 4.0% (1/25) of ABCA patients had event of stroke or transient ischemic attack (TIA) ( p =0.08).
Conclusion:
The prevalence of ABCA in the present study is significantly lower than that in previous studies (Togay-Isikay et al., 24.6%, Del Corso et al., 58%). ABCA is more frequent in women and older patients. ABCA is not related to stroke and stroke risk factors. From our results, we suggest that patients with ABCA be placed under observation unless they exhibit neurological symptoms.
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