Elongated Internal Carotid Arteries in Patients with Severe Carotid Artery Stenosis
Tomoaki Tamada1, Toshio Imaizumi1, Shoichi Komura1
1Department of Neurosurgery, Kushiro City General Hospital, Kushiro, Hokkaido,Japan.
Insights
Elongated internal carotid arteries (ICAs) are linked to older age and white matter changes, but not severe carotid artery stenosis. This finding helps understand stroke risk factors in aging populations.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Elongated internal carotid arteries (ICAs) are increasingly recognized, but their association with cerebrovascular diseases and risk factors requires further investigation.
- Understanding the relationship between ICA elongation and conditions like carotid artery (CA) stenosis is crucial for stroke prevention.
Purpose of the Study:
- To investigate risk factors and asymptomatic cerebrovascular diseases associated with elongated ICAs.
- To explore the relationship between ICA elongation and severe CA stenosis.
Main Methods:
- Retrospective analysis of 53 patients with severe CA stenosis and 400 controls using magnetic resonance angiography (MRA).
- ICA elongation measured by ICA distance (≥ 1.2 cm vs. < 1.2 cm).
- Comparison of asymptomatic findings (cerebral microbleeds, lacunar infarctions, deep white matter hyperintensities) and stroke risk factors using multivariate logistic regression.
Main Results:
- ICA elongation (ICA distance ≥ 1.2 cm) was associated with age ≥ 65 years (OR=1.8) and severe deep white matter hyperintensities (WMHs) (OR=2.0).
- ICA elongation was negatively associated with severe CA stenosis (OR=0.17), suggesting a complex relationship.
- The study identified specific associations between ICA elongation, age, WMHs, and CA stenosis.
Conclusions:
- ICA elongation is positively associated with advanced age and deep white matter hyperintensities.
- ICA elongation shows a negative association with severe carotid artery stenosis.
- These findings contribute to understanding the clinical significance of ICA elongation in cerebrovascular health.
Objective:
This study aimed to investigate the risk factors and asymptomatic cerebrovascular diseases associated with elongated internal carotid arteries (ICAs) and the relationship between ICA elongation and severe carotid artery (CA) stenosis.
Methods:
We evaluated risk factors for stroke and magnetic resonance imaging (MRI) findings in patients with severe CA stenosis compared with people without neurological disorders who underwent brain screening (controls). On magnetic resonance angiography (MRA) images, we measured the longest distance, defined as the ICA distance, from the most distant anterior wall of the cervical ICA at the site of bending or kinking to the line between the origin of the external CA and the anterior protrusion of the ICA near the petrosal bone. We retrospectively compared various asymptomatic findings, including cerebral microbleeds, lacunar infarctions, and deep white matter hyperintensities (WMHs), between participants with an ICA distance ≥ 1.2 cm vs. < 1.2 cm. The prevalence of findings and stroke risk factors were compared using multivariate logistic regression models.
Results:
We evaluated 53 patients (70.0 ± 8.1 years old, nine female) with severe CA stenosis treated by CA stenting and 400 controls (63.0 ± 9.2 years old, 227 females). Multivariate analyses showed that ICA distance ≥ 1.2 cm was associated with age ≥ 65 years (odds ratio (OR) = 1.8, p < 0.01), severe deep WMHs (OR = 2.0, p = 0.02), and severe CA stenosis (OR = 0.17, p < 0.01).
Conclusion:
ICA elongation, measured by ICA distance, was positively associated with age and deep WMHs and negatively associated with severe CA stenosis.
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