Asymptomatic Basilar Artery Plaque Distribution and Vascular Geometry

Area of Science:

• Vascular imaging and hemodynamics.
• Cerebrovascular atherosclerosis research.

Background:

• Atherosclerotic plaque development is influenced by vascular geometry and blood flow dynamics.
• The basilar artery (BA) exhibits unique hemodynamics due to the convergence of flow from the vertebral arteries (VAs).

Purpose of the Study:

• To investigate the characteristics of basilar artery (BA) plaques in relation to vertebral artery (VA) and BA geometry.
• To understand how vascular geometry influences BA plaque distribution.

Main Methods:

• Magnetic resonance imaging (MRI) was used to assess geometric characteristics of VA and BA in 1029 subjects.
• VA dominancy, VA-BA angles, BA convexity, and BA angles were evaluated.
• BA plaque burden was analyzed across anterior, posterior, left, and right lateral walls and correlated with geometry and plaque burden tertiles.

Main Results:

• Basilar artery (BA) plaques were found in 9.5% of subjects, predominantly on anterior and posterior walls.
• Lateral plaques correlated with BA convexity, and anterior plaques with a low lateral mid-BA angle.
• Plaques shifted from anterior/posterior to lateral walls as plaque burden increased.

Conclusions:

• Asymptomatic BA plaque location is associated with BA convexity and lateral mid-BA angle.
• Increasing plaque burden may lead to the extension of anterior and posterior BA plaques to the lateral walls.