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.

中文翻译：

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颈内动脉盘绕与疑似卒中患者的高血压有关

目的

对颈内动脉 (ICA) 颅外部分盘绕（即严重伸长）的病因知之甚少，提出的病因是先天性、动脉粥样硬化或高血压。目的是调查线圈与高血压、颈动脉粥样硬化和其他心血管危险因素的关联。

方法

在怀疑中风的患者中进行了一项病例对照研究，根据计算机断层扫描血管造影 (CTA) 确定有（病例）或没有（对照）ICA 盘绕。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 的盘绕和颈动脉分叉处的动脉粥样硬化斑块。进行了逻辑回归分析。

结果

在 108 名中位年龄为 71 岁的患者中发现了盘绕。病例与 256 名中位年龄为 69 岁的对照组进行了比较。63% 的卷曲患者出现高血压，而对照组为 51%。单变量分析显示高血压与卷曲显着相关，优势比为 1.65（95% 置信区间 (CI) 1.04–2.61，p  = 0.034）。校正年龄和性别的多变量分析导致优势比为 1.71（95% CI 1.05–2.80，p  = 0.032），而校正分叉处的动脉粥样硬化斑块产生的优势比为 1.63（95% CI 1.00–2.66，p  = 0.049）。年龄和动脉粥样硬化斑块与卷曲没有显着相关性。

结论

该研究的主要发现是高血压与 ICA 的卷曲显着相关，并且与年龄、斑块和除高血压以外的动脉粥样硬化危险因素无关。