Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Clin Neuroradiol. 2021 Jun;31(2):425-430. doi: 10.1007/s00062-020-00892-4. Epub 2020 Mar 18.
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.
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.
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.
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.
颅外颈内动脉（ICA）卷曲（即严重伸长）的病因尚不清楚，提出的病因包括先天性、动脉粥样硬化或高血压。目的是研究卷曲与高血压、颈动脉粥样硬化和其他心血管危险因素的关系。
对疑似中风的患者进行病例对照研究，通过计算机断层血管造影（CTA）确定 ICA 是否卷曲（病例组）或不卷曲（对照组）。基线特征包括年龄、性别、高血压、糖尿病、吸烟和高胆固醇血症。在 CTA 上评估 ICA 卷曲和颈动脉分叉处的粥样硬化斑块。进行逻辑回归分析。
在 108 例 ICA 卷曲的患者中，年龄中位数为 71 岁。将病例组与年龄中位数为 69 岁的 256 例对照组进行比较。在 ICA 卷曲的患者中，高血压的发生率为 63%，而对照组为 51%。单变量分析显示，高血压与 ICA 卷曲显著相关，优势比为 1.65（95%置信区间 1.04-2.61，p=0.034）。校正年龄和性别后的多变量分析得出的优势比为 1.71（95%置信区间 1.05-2.80，p=0.032），而校正分叉处粥样硬化斑块后的优势比为 1.63（95%置信区间 1.00-2.66，p=0.049）。年龄和粥样硬化斑块与卷曲无显著相关性。
本研究的主要发现是高血压与 ICA 卷曲显著相关，而与年龄、斑块和除高血压以外的动脉粥样硬化危险因素无相关性。
