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

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 retrospec...

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Bibliographic Details
Published in:PloS one 2020-01, Vol.15 (1), p.e0228041-e0228041
Main Authors: van Laarhoven, Constance J H C M, Pourier, Vanessa E C, Lindgren, Antti E, Vergouwen, Mervyn D I, Jääskeläinen, Juha E, Rinkel, Gabriël J E, de Kleijn, Dominique P V, de Borst, Gert J
Format: Article
Language:English
Subjects:
Aneurysm
Aneurysms
Angiography, Digital Subtraction
Bifurcations
Biology and Life Sciences
Brain research
Carotid arteries
Carotid Arteries - diagnostic imaging
Carotid Arteries - pathology
Carotid artery
Cerebral aneurysm
Cohort Studies
Comparative analysis
Diabetes
Europe - epidemiology
Female
Humans
Image analysis
Image processing
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - epidemiology
Logistic Models
Male
Medical imaging
Medicine and Health Sciences
Middle Aged
Neurosurgery
Patients
People and Places
Prevalence
Stroke
Vascular surgery
Veins & arteries
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Summary: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. 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. 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). 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.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0228041