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Use of Carotid Web Angioarchitecture for Stroke Risk Assessment.

Grace G von Oiste¹, Karl L Sangwon¹, Charlotte Chung¹

¹Department of Neurosurgery, NYU Langone Health, New York, New York, USA.

World Neurosurgery

|November 25, 2023

Summary

Carotid web (CW) and carotid bifurcation angioarchitecture measurements can assess stroke risk. Specific angles of the ICA and CCA pouch tip and web-pouch are key indicators for stroke risk stratification.

Keywords:

Carotid bifurcation Carotid web Firth regression Ischemic stroke Machine learning Principal component analysis

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Area of Science:

Vascular Neurology
Medical Imaging
Biomedical Engineering

Background:

Carotid web (CW) is an anatomical variation that may be associated with stroke.
Assessing stroke risk is crucial for preventative care and patient management.

Purpose of the Study:

To evaluate the utility of carotid web (CW) and carotid bifurcation angioarchitecture in predicting stroke risk.
To develop a model for stroke risk stratification using these anatomical measurements.

Main Methods:

Retrospective analysis of computed tomography angiography data from patients with CW.
Development of a stroke risk model using principal-component analysis and Firth regression.
Identification of key angioarchitectural features through cross-validation and heuristic cutoffs.

Main Results:

The study included 22 patients (11 with ischemic stroke).
Key predictors of stroke risk included ICA-pouch tip angle, CCA-pouch tip angle, ICA web-pouch angle, and CCA web-pouch angle.
Standard carotid artery (CCA and ICA) diameter and angle were not significant risk factors.

Conclusions:

Carotid web and carotid bifurcation angioarchitecture, particularly specific angles, can effectively assess stroke risk.
This approach allows for personalized risk stratification and tailored patient care.
Further research can validate these findings in larger cohorts.