Carotid angle in young stroke.

Purpose: To investigate whether the carotid bifurcation angle as assessed by computed tomographic angiography (CTA) is associated with anterior circulation ischemic stroke (ACIS) in young patients.

Material And Methods: Thirty patients (mean age 41.5 ± 6 years) with known acute ACIS (group 1) were compared to 30 control patients (mean age/ 41.2 ± 6 years) (group 2) with similar demographic variables in this retrospective study. Geometrical characteristics of bilateral carotid bifurcation were obtained by CTA. The ICA bifurcation (ICAB) angle, the carotid central bifurcation (CCB), and the carotid bifurcation wall (CBW) angle among the ICA, CCA, and ECA were measured. Carotid artery angle measurements were compared between group 1 and group 2. The comparison of pathological (ACIS) and non-pathological (non-ACIS) carotid sides in group 1 was performed as well.

Results: All the measured angles (AMA) of group 1 were higher than group 2 (p˂0.05). In patients with left-sided ACIS, AMA on the left side were higher than the right side (p˂0.05), this was more prominent in males (p˂0.05). All angles measured were found to be higher in ipsilateral ACIS (p˂0.05). The left CCB angle values had a significant effect on ischemic stroke (p˂0.05). Male patients had more left-sided ACIS (p˂0.05). Plaque development in ICA was found statistically significant in group 1 compared to group 2 (p˂0.05).

Conclusion: Carotid artery geometry may play an important role in the development of ischemic events in young patients, especially in men and, also in patients with left-sided stroke. The left CCB angle had a significant effect on ACIS.