Correlation between Osteal Kneading and Carotid Artery Atherosclerotic Plaque

Adjacent bony structures may directly rub the carotid artery during swallowing or head and neck movement. Long-term repeated stimulation might be considered to be a potential risk factor for carotid atherosclerotic plaque formation, development, and hazard. We defined the process as "osteal kneading".

A total of 192 consecutive (384 carotid arteries) neck computed tomography angiographies and cerebral magnetic resonance imaging performed within 1 month were analyzed. Ipsilateral bones (thyroid cartilage and hyoid bone), carotid arteries, and plaque were characterized using the computed tomography angiography images. Cerebral ischemic lesions were analyzed using the magnetic resonance images. According to the relationship between the position of the plaque and the bony structures, the vessels were divided into the osteal kneading positive group (OK+) and the osteal kneading negative group (OK-). The effects of osteal kneading on plaque formation, development, and hazard were then explored.

As seen, 95.7% of the OK+ plaques were located in the common carotid artery. The thyroid cartilage and hyoid bone were significantly closer to the carotid artery wall (P < 0.001), and the vascular radius was significantly larger (P < 0.001) in the OK+ group. The distance from the thyroid cartilage and hyoid bone to the ipsilateral carotid arteries was negatively correlated with plaque thickness, carotid artery stenosis rate, and calcified plaque occurrence (P < 0.05).

This pilot study provides preliminary evidence for the hypothesis of "osteal kneading" of the carotid artery and also suggests that osteal kneading may play some role in carotid artery plaque formation and development. Further research is required to provide more concrete evidence for the hypothesis, such as the inclusion of samples from multiple centers, precise outcome observation, artificial intelligence-assisted image analysis, and dynamic evaluation methods.