Dissecting Aneurysm in Cervical Artery Dissection: Insights From the STOP-CAD Study

Area of Science:

• Neurology
• Vascular Medicine
• Cardiology

Background:

• Cervical artery dissection (CeAD) can lead to dissecting aneurysm (DA) formation.
• Understanding risk factors and outcomes of DA in CeAD is crucial for patient management.

Purpose of the Study:

• To identify risk factors associated with DA in a large international CeAD cohort.
• To evaluate the clinical outcomes, including stroke and hemorrhage, related to DA formation.

Main Methods:

• Secondary analysis of the international, multicenter, retrospective STOP-CAD cohort.
• Assessment of baseline and de novo DA formation in patients with spontaneous CeAD.
• Multivariable regression and Cox proportional hazards models to identify associated factors and clinical outcomes.

Main Results:

• 13.6% of 4,008 CeAD patients had baseline DA; 7.5% developed de novo DA, mostly within 180 days.
• DA associated with connective tissue disorder, fibromuscular dysplasia, and multiple vessel dissection.
• Lower odds of DA seen in Hispanic ethnicity and ischemic stroke presentation; fibromuscular dysplasia linked to de novo DA.
• DA was not associated with increased risk of ischemic stroke or intracranial hemorrhage by 180 days.

Conclusions:

• Dissecting aneurysms are frequent in CeAD, typically manifesting within six months.
• DA presence does not appear to elevate the risk of subsequent ischemic stroke or intracranial hemorrhage.