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Morphological changes of the internal carotid artery: prevalence and characteristics. A clinical and ultrasonographic study in a series of 19 804 patients over 25 years old
Author(s) -
Martins H. F. G.,
Mayer A.,
Batista P.,
Soares F.,
Almeida V.,
Pedro A. J.,
Oliveira V.
Publication year - 2018
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13491
Subject(s) - medicine , confidence interval , etiology , statistical significance , internal carotid artery , logistic regression , odds ratio , carotid arteries , multivariate analysis , ultrasound , transcranial doppler , stroke (engine) , cardiology , radiology , mechanical engineering , engineering
Background and purpose Morphological changes of the internal carotid arteries (Mc ICA ) are frequently found during cervical ultrasound studies. However, the etiology of Mc ICA remains controversial. During this study, the prevalence and demographic characteristics of Mc ICA , such as kinking, coiling or looping identified by Doppler ultrasound, were analysed and its relationship with vascular risk factors and stroke was assessed. Methods A retrospective study was performed by analysing 19 804 patients who were subjected to cervical ultrasonographic study between January 2000 and June 2012. The data were statistically analysed with SPSS ® 20 and a multivariate logistic regression was performed. Statistical significance was accepted for P < 0.05 and 95% confidence intervals ( CIs ) were used. Results Morphological changes of the internal carotid arteries were present in 2678 patients (13.5%) and were unilateral in 61.6% of these cases. Carotid kinking was found in 80% of the patients, coiling in 16% and looping in 1%. In multivariate analysis, the presence of Mc ICA was related to older groups (1.04; 95% CI , 1.04–1.05; P < 0.01), female gender (1.78; 95% CI , 1.64–1.94; P < 0.01), patients with hyperlipidemia (1.28; 95% CI , 1.17–1.40; P < 0.01), carotid thickness (1.22; 95% CI , 1.13–1.33; P < 0.01) and cardiac or cardioembolic disease (1.11; 95% CI , 1.01–1.21; P = 0.02). The results of this study indicate that kinking in the carotid artery was associated with ipsilateral cerebral ischemic events (1.43; 95% CI , 1.040–1.958; P < 0.05). Conclusion Morphological changes of the internal carotid arteries were associated with aging, female gender and patients with hyperlipidemia, hypertension, diabetes and heart disease. Kinking was associated with ipsilateral cerebral ischemia.