Relationship between carotid artery atherosclerosis and bulb geometry

Abstract

The carotid bifurcation is a common site of atherosclerotic plaque. Plaque development is thought to occur preferentially at geometrically predisposed areas such as arterial branch points. The aim of this study was to investigate the geometric and anatomical variables that contribute to the development of carotid plaque using three-dimensional (3D) ultrasound. Sixty-seven consecutive outpatients referred for elective coronary angiography underwent 3D carotid ultrasound scans for the purpose of carotid plaque quantification. Geometric quantification of the left and right carotid bulbs were performed retrospectively on this study population. Geometric values such as angle, area and length of the carotid bulb and the bifurcation were determined using QLAB software (Philips Healthcare). Plaque volume within the carotid bulb and artery branches was quantified using the stacked contour method. Pearson's correlation and linear regression analysis were used to determine the relationship between anatomical variables and plaque volume. The mean age for the total patient population was 65.9 ± 11.5 years. Carotid bulb inflow area (BIA) (r = 0.28, p = 0.001), bulb volume (BV) (r = 0.21, p = 0.01) and bifurcation angle (BifA) (r = 0.18, p = 0.04) showed a positive linear relationship with plaque volume. In contrast, internal carotid artery angle (ICAA) (r = - 0.18, p = 0.04) and bulb flare (r = - 0.20, p = 0.02) displayed a negative linear relationship with plaque volume. When adjusting for age and sex, only the BIA remained significant (β = 0.18, p = 0.04). Geometric variables were identified as potential risk factors associated with plaque volume in the carotid bulb. Further analysis of the evolution of the BIA as well as the relationship to other geometric variables could create a stronger predictive model of atherosclerosis as well as assist in preoperative planning.

Longitudinal study of carotid artery bifurcation geometry using magnetic resonance angiography

“…5,13 Furthermore, a study by Gregg noted an opposed result, in which they revealed a negative correlation between ICA angle and plaque volume. 14 The impact of hemodynamic factors on the progression of atherosclerotic disease has been highlighted. Blood vessels are constantly exposed to several mechanical forces exerted on their walls, including the circumference of the vessel.…”

“…5,13 Furthermore, a study by Gregg noted an opposed result, in which they revealed a negative correlation between ICA angle and plaque volume. 14…”

Cardiovascular risk assessment in patients with rheumatoid arthritis using carotid ultrasound B-mode imaging

“…However, several studies have reported more aggressive atherosclerotic plaque formation in the carotid bulb segment when compared to other arterial segments [ 94 ]. The higher plaque prevalence in the carotid bulb is a consequence of turbulent blood flow and reduced shear stress, which leads to endothelial dysfunction [ 95 , 96 ]. This observation of higher plaque in a bulb has also been confirmed in RA patients [ 40 ].…”

Does the Carotid Bulb Offer a Better 10-Year CVD/Stroke Risk Assessment Compared to the Common Carotid Artery? A 1516 Ultrasound Scan Study

“…25,27 However, atherosclerosis primarily begins at the bifurcation zone such as the carotid bulb (CB). 28,29 The growth of atherosclerosis in CB is a consequence of turbulent blood flow and reduced shear stress that leads to endothelial dysfunction. 28,29 Several studies have provided evidence of high atherosclerotic plaque in the CB region compared to other arterial segments.…”

“…28,29 The growth of atherosclerosis in CB is a consequence of turbulent blood flow and reduced shear stress that leads to endothelial dysfunction. 28,29 Several studies have provided evidence of high atherosclerotic plaque in the CB region compared to other arterial segments. 28,30 –39 Furthermore, it has been shown that plaque in CB has also been associated with coronary artery disease and myocardial infarction.…”