Arterial wall properties in carotid artery dissection - An ultrasound study

Background: Cervical artery dissection is often attributed to an underlying arteriopathy related to a generalized extracellular matrix defect. Objecti ve: The authors compared the hemodynamic and morphologic properties of the carotid artery, as assessed noninvasively by ultrasonography, in patients w ith spontaneous internal carotid artery dissection (ICAD) and control subje cts. Method: Twenty-six patients who experienced ICAD more than 6 months be fore evaluation were compared with 26 controls matched for age, sex, and he ight. Cases and controls had ultrasound measurement of common carotid arter y diameter and diameter change during the cardiac cycle, bulbar and suprabu lbar internal carotid artery diameters, and common carotid artery intima-me dia thickness. The unaffected carotid artery in cases was compared with the carotid artery of the same side in controls. Results: Common carotid arter y relative diameter change was significantly higher in cases than controls, whereas other measurements were not significantly different between the gr oups. In multivariate analyses, the highest tertile of common carotid arter y relative diameter change was associated with the risk of ICAD (OR, 10.0; 95% CI, 1.8 to 54.2; p = 0.002) Conclusion: An underlying arteriopathy, pre sumably related to an extracellular matrix defect, may be present in patien ts with spontaneous ICAD.