Co-prevalence of extracranial carotid aneurysms differs between European intracranial aneurysm cohorts


Autoři: Constance J. H. C. M. van Laarhoven aff001;  Vanessa E. C. Pourier aff001;  Antti E. Lindgren aff002;  Mervyn D. I. Vergouwen aff003;  Juha E. Jääskeläinen aff002;  Gabriël J. E. Rinkel aff003;  Dominique P. V. de Kleijn aff001;  Gert J. de Borst aff001
Působiště autorů: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands aff001;  Department of Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland aff002;  Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0228041

Souhrn

Background and purpose

Previously, we showed that co-prevalence of extracranial carotid artery aneurysms (ECAAs) in patients with intracranial aneurysms (IAs) was 2% in a Dutch cohort. In order to obtain more precise estimates and discover potential predictors of ECAA co-prevalence in the European population, we retrospectively compared differences and similarities of our Dutch cohort with a Finnish cohort using protocolled imaging of the cerebrovascular tree.

Methods

IA patients within the prospective database of the Kuopio University Hospital were eligible for this study (n = 1,118). Image analysis and hospital chart review were conducted.

Results

In total, 458 patients with complete carotid imaging conform protocol were analyzed. Twenty-four ECAAs in 21 patients were identified (4.6%, 95% CI 2.9–6.9), a higher co-prevalence than in the Dutch cohort (1.9%; 95% CI 1.0–3.3), prevalence odds ratio (POR) 2.45 (95% CI 1.19–5.03). In the Finnish cohort, 25% of all ECAAs were located around the carotid bifurcation, others in the internal carotid artery distally from the bifurcation. Independent predictors for ECAA co-prevalence were origin of country (POR 2.41, 95% CI 1.15–5.06) and male gender (POR 2.25, 95% CI 1.09–4.64).

Conclusion

The co-prevalence of ECAA in IA patients was twice as high in the Finnish compared to the Dutch IA cohort, with origin of country and male gender as independent predictors. Twenty-five percent of ECAAs would be missed, if the carotid bifurcation was not imaged. Therefore, we propose to always include imaging of the carotid bifurcation as the gold standard technique to identify ECAA in IA patients.

Klíčová slova:

Aneurysms – Carotid arteries – Diabetes mellitus – Dutch people – Hypertension – Radiology and imaging – Statins – Arterial bifurcations


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2020 Číslo 1