TY - JOUR
T1 - Coiling of the Internal Carotid Artery is Associated with Hypertension in Patients Suspected of Stroke
AU - van Rooij, Josephus L M
AU - Takx, Richard A P
AU - Velthuis, Birgitta K
AU - Dankbaar, Jan Willem
AU - de Jong, Pim A
N1 - Funding Information:
The Dutch acute stroke study (DUST) investigators are: Academic Medical Center, Amsterdam, The Netherlands (Majoie CB, Roos YB); Catharina Hospital, Eindhoven, The Netherlands (Duijm LE, Keizer?K); Erasmus Medical Center, Rotterdam, The Netherlands (van der Lugt A, Dippel DW); Gelre Hospitals, Apeldoorn, The Netherlands (Droogh-de Greve KE, Bienfait HP); Leiden University Medical Center, Leiden, The Netherlands (van Walderveen MA, Wermer MJ); Medical Center Haaglanden, The Hague, The Netherlands (Lycklama ??Nijeholt GJ, Boiten?J); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (Duyndam?D, Kwa?VI); Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands (Meijer FJ, van Dijk EJ); Rijnstate Hospital, Arnhem, The Netherlands (Kesselring FO, Hofmeijer?J); St. Antonius Hospital, Nieuwegein, The Netherlands (Vos JA, Schonewille WJ); St. Elisabeth Hospital, Tilburg, The Netherlands (van Rooij WJ, de Kort PL); St. Franciscus Hospital, Rotterdam, The Netherlands (Pleiter CC, Bakker SL); VU Medical Center, Amsterdam, The Netherlands (Bot?J, Visser MC); University Medical Center Utrecht, Utrecht, The Netherlands (Velthuis BK, van der Schaaf IC, Dankbaar JW, Mali WP, van Seeters?T, Horsch AD, Niesten JM, Biessels GJ, Kappelle LJ, Luitse MJ, van der Graaf?Y).
Funding Information:
The DUST study was supported by grants from the Netherlands Heart Foundation (grant numbers 2008 T034 and 2012 T061) and the NutsOhra Foundation (grant number 0903-012). Acknowledgements
Publisher Copyright:
© 2020, The Author(s).
PY - 2021/6
Y1 - 2021/6
N2 - PURPOSE: The etiology of coiling (i.e. severe elongation) of the extracranial part of the internal carotid artery (ICA) is poorly understood with the proposed etiology being congenital, atherosclerotic or hypertension. The objective was to investigate the association of coiling with hypertension, carotid artery atherosclerosis and other cardiovascular risk factors.METHODS: A case control study was performed in patients suspected of stroke, with (cases) or without (controls) coiling of the ICA determined on compute tomography angiography (CTA). Baseline characteristics included age, gender, hypertension, diabetes, smoking and hypercholesterolemia. Coiling of the ICA and atherosclerotic plaque at the carotid bifurcation were assessed on CTA. Logistic regression analyses were conducted.RESULTS: Coiling was identified in 108 patients with a median age of 71 years. Cases were compared with 256 controls with a median age of 69 years. Hypertension was present in 63% of the patients with coiling compared to 51% in the control group. Univariable analysis showed that hypertension was significantly associated with coiling, with an odds ratio of 1.65 (95% confidence interval (CI) 1.04-2.61, p = 0.034). Multivariable analysis corrected for age and sex resulted in an odds ratio of 1.71 (95% CI 1.05-2.80, p = 0.032), while correcting for atherosclerotic plaque at the bifurcation yielded an odds ratio of 1.63 (95% CI 1.00-2.66, p = 0.049). Age and atherosclerotic plaque were not significantly associated with coiling.CONCLUSION: The main finding of this study was the significant association of hypertension with coiling of the ICA and the absence of an association with age, plaques and atherosclerotic risk factors other than hypertension.
AB - PURPOSE: The etiology of coiling (i.e. severe elongation) of the extracranial part of the internal carotid artery (ICA) is poorly understood with the proposed etiology being congenital, atherosclerotic or hypertension. The objective was to investigate the association of coiling with hypertension, carotid artery atherosclerosis and other cardiovascular risk factors.METHODS: A case control study was performed in patients suspected of stroke, with (cases) or without (controls) coiling of the ICA determined on compute tomography angiography (CTA). Baseline characteristics included age, gender, hypertension, diabetes, smoking and hypercholesterolemia. Coiling of the ICA and atherosclerotic plaque at the carotid bifurcation were assessed on CTA. Logistic regression analyses were conducted.RESULTS: Coiling was identified in 108 patients with a median age of 71 years. Cases were compared with 256 controls with a median age of 69 years. Hypertension was present in 63% of the patients with coiling compared to 51% in the control group. Univariable analysis showed that hypertension was significantly associated with coiling, with an odds ratio of 1.65 (95% confidence interval (CI) 1.04-2.61, p = 0.034). Multivariable analysis corrected for age and sex resulted in an odds ratio of 1.71 (95% CI 1.05-2.80, p = 0.032), while correcting for atherosclerotic plaque at the bifurcation yielded an odds ratio of 1.63 (95% CI 1.00-2.66, p = 0.049). Age and atherosclerotic plaque were not significantly associated with coiling.CONCLUSION: The main finding of this study was the significant association of hypertension with coiling of the ICA and the absence of an association with age, plaques and atherosclerotic risk factors other than hypertension.
KW - Coiling
KW - Dolichoarteriopathy
KW - Hypertension
KW - Internal carotid artery
KW - Tortuosity
UR - https://www.scopus.com/pages/publications/85082059340
U2 - 10.1007/s00062-020-00892-4
DO - 10.1007/s00062-020-00892-4
M3 - Article
C2 - 32189014
SN - 1869-1439
VL - 31
SP - 425
EP - 430
JO - Clinical Neuroradiology
JF - Clinical Neuroradiology
IS - 2
ER -