1
|
Ren L, Xu R, Zhao C, Li W, Wang S, Cao C, Gong Y, Zhu J, Feng X, Ren B, Xia S. Tortuosity and Proximal-Specific Hemodynamics Associated with Plaque Location in the Carotid Bulb Stenosis. J Vasc Res 2023; 60:160-171. [PMID: 37499638 DOI: 10.1159/000531584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/14/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Atherosclerotic plaque locations in the carotid bulb increasingly have been found to be associated with patterns of ischemic lesions and plaque progression. However, the occurrence of carotid bulb plaque is a complex process. We aimed to investigate plaque characteristics and geometric and hemodynamic parameters among patients with body and apical plaques of the carotid bulb and to identify the mechanism of bulb plaque formation and location. METHODS Consecutive patients with single carotid bulb stenosis (50-99%) were enrolled retrospectively. Patients were divided into body and apical plaque groups based on plaque location. Plaque location and characteristics were identified and measured on high-resolution vessel wall magnetic resonance imaging. Geometric parameters were derived from time-of-flight magnetic resonance imaging. Computational fluid dynamics simulations were performed to quantify wall shear stress (WSS) and four associated WSS-based metrics on the plaque side, on the non-plaque side, and in different parts of the lesion. Plaque characteristics and geometric and hemodynamic parameters were compared, and their associations with the plaque location were determined. RESULTS Seventy patients were recruited (41 body plaques and 29 apical plaques). WSSplaque values were lower than WSSnon-plaque values for all plaques (median [interquartile range], 12.59 [9.83-22.14] vs. 17.27 [11.63-27.63] Pa, p = 0.001). In a multivariate binary logistic regression, the tortuosity of the stenosed region, the magnitudes of the mean relative residence time, and the minimum transverse WSS in the proximal part of the lesion were the key factors independently associated with plaque location (p = 0.022, 0.013, and 0.012, respectively). CONCLUSIONS Plaque formation was associated with the local flow pattern, and the tortuosity and proximal-specific hemodynamics were significantly associated with plaque location in the carotid bulb.
Collapse
Affiliation(s)
- Lei Ren
- Department of Radiology, First Central Clinical School, Tianjin Medical University, Tianjin, China
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Rongjie Xu
- College of Computer Science, Nankai University, Tianjin, China
| | - Chenxi Zhao
- Department of Radiology, First Central Clinical School, Tianjin Medical University, Tianjin, China
| | - Wenfei Li
- Department of Radiology, First Central Clinical School, Tianjin Medical University, Tianjin, China
- Department of Radiology, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Shu Wang
- Department of Breast Oncoplastic Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Chen Cao
- Department of Radiology, Tianjin University Huanhu Hospital, Tianjin, China
| | - Yan Gong
- Department of Radiology, Tianjin Nankai Hospital, Tianjin, China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Xuequan Feng
- Department of Neurosurgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Bo Ren
- College of Computer Science, Nankai University, Tianjin, China
| | - Shuang Xia
- Department of Radiology, Medical Imaging Institute of Tianjin, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China
| |
Collapse
|
2
|
Kobayashi Y, Ishiguro H, Fujikawa T, Kobayashi H, Sumida K, Kagimoto M, Okuyama Y, Ehara Y, Katsumata M, Fujita M, Fujiwara A, Saka S, Yatsu K, Hirawa N, Toya Y, Yasuda G, Umemura S, Tamura K. Atherosclerosis of the carotid bulb is associated with the severity of orthostatic hypotension in non-diabetic adult patients: a cross-sectional study. Clin Exp Hypertens 2018; 41:1-8. [PMID: 29672186 DOI: 10.1080/10641963.2018.1465073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/20/2018] [Accepted: 04/10/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The carotid bulb has a high density of baroreceptors that play an important role in maintaining blood pressure. We hypothesized that atherosclerosis of the carotid bulb would reflect the severity of orthostatic hypotension more accurately than would atherosclerosis of other carotid artery segments. METHODS This cross-sectional study included 198 non-diabetic adults. We measured the cardio-vascular ankle index as an index of arterial stiffness, intima-media thickness in each carotid artery segment (internal carotid artery, carotid bulb, distal and proximal portions, respectively, of the common carotid artery) as a measure of atherosclerosis, and heart rate variability as a measure of cardiac autonomic function. The sit-to-stand test was used to assess severity of orthostatic hypotension. RESULTS Intima-media thickness of the carotid bulb was correlated with orthostatic systolic blood pressure change (r = -0.218, p = 0.002), cardio-ankle vascular index (r = 0.365, p < 0.001) and heart rate variability parameters. Multivariate regression analysis revealed that among all of the segments, only intima-media thickness of the carotid bulb was an independent predictor of orthostatic systolic blood pressure change (p = 0.022). CONCLUSION Atherosclerosis of the carotid bulb was associated with severity of orthostatic hypotension, arterial stiffening and cardiac autonomic dysfunction than that of other carotid artery segments.
Collapse
Affiliation(s)
- Yusuke Kobayashi
- a Division of Nephrology and Hypertension , Saiseikai Yokohamashi Nanbu Hospital , Yokohama , Japan
- b Department of Internal Medicine , The Kobayashi Medical Clinic , Yokohama , Japan
| | - Hiroaki Ishiguro
- c Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Tetsuya Fujikawa
- c Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- d Center for Health Service Sciences , Yokohama National University , Yokohama , Japan
| | - Hideo Kobayashi
- b Department of Internal Medicine , The Kobayashi Medical Clinic , Yokohama , Japan
| | - Koichiro Sumida
- c Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Minako Kagimoto
- c Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Yuki Okuyama
- a Division of Nephrology and Hypertension , Saiseikai Yokohamashi Nanbu Hospital , Yokohama , Japan
- c Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Yosuke Ehara
- c Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Mari Katsumata
- c Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Megumi Fujita
- c Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Akira Fujiwara
- e Department of Nephrology and Hypertension , Yokohama City University Medical Center , Yokohama , Japan
| | - Sanae Saka
- e Department of Nephrology and Hypertension , Yokohama City University Medical Center , Yokohama , Japan
| | - Keisuke Yatsu
- c Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Nobuhito Hirawa
- e Department of Nephrology and Hypertension , Yokohama City University Medical Center , Yokohama , Japan
| | - Yoshiyuki Toya
- c Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Gen Yasuda
- e Department of Nephrology and Hypertension , Yokohama City University Medical Center , Yokohama , Japan
| | - Satoshi Umemura
- f Department of Internal Medicine , Yokohama Rosai Hospital , Yokohama , Japan
| | - Kouichi Tamura
- c Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| |
Collapse
|
3
|
Ulusoy OL, Sasani H, Barlas SB, Mutlu A, Sasani M. A Case of Anomalous Origin and Course of Vertebral Artery in a Patient with Klippel Feil Syndrome. Korean J Radiol 2016; 17:554-7. [PMID: 27390547 PMCID: PMC4936178 DOI: 10.3348/kjr.2016.17.4.554] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 04/15/2016] [Indexed: 11/15/2022] Open
Abstract
Patients with Klippel-Feil syndrome (KFS) have an increased incidence of vascular anomalies as well as vertebral artery (VA) anomalies. In this article, we presented imaging findings of a 15-year-old female patient with KFS with a rare association of extraforaminal cranially ascending right VA that originated from the ipsilateral carotid bulb. Trifurcation of the carotid bulb with VA is a very unusual variation and to the best of our knowledge, right-sided one has not been reported in the literature.
Collapse
Affiliation(s)
- Onur Levent Ulusoy
- Department of Radiology, Istanbul Florence Nightingale Hospital, Istanbul 34381, Turkey
| | - Hadi Sasani
- Department of Radiology, Near East University School of Medicine, Nicosia 99138, Northern Cyprus
| | - Sezgi Burçin Barlas
- Department of Radiology, Istanbul Florence Nightingale Hospital, Istanbul 34381, Turkey
| | - Ayhan Mutlu
- Department of Radiology, Istanbul Florence Nightingale Hospital, Istanbul 34381, Turkey
| | - Mehdi Sasani
- Department of Anatomy, Trakya University, Faculty of Medicine, Edirne 22030, Turkey
| |
Collapse
|