Dolichoarteriopathies of the extracranial internal carotid artery: The Plaque At RISK study

Kristine Dilba, Dianne H. K. Van Dam-Nolen, Genevieve A. J. C. Crombag, Anja G. van der Kolk, Peter J. Koudstaal, Paul J. Nederkoorn, Jeroen Hendrikse, Marianne Eline Kooi, Antonius F. W. van der Steen, Jolanda J. Wentzel, Aad van der Lugt, Daniel Bos*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background and purpose Dolichoarteriopathies of the extracranial part of the internal carotid artery (ICA) are associated with cerebrovascular events, yet information on their prevalence and risk factors remains limited. The aim of the present study therefore was to study the prevalence and risk factors of dolichoarteriopathies in a sample of patients with cerebrovascular symptoms from the Plaque At RISK (PARISK) study. Methods In a random sample of 100 patients from the PARISK study, multidetector computed tomography angiography (MDCTA) was performed as part of clinical workup. On MDCTA, we evaluated the extracranial trajectory of the ICA by measuring the length (in millimeters), the tortuosity index (TI; defined as the ICA length divided by the shortest possible distance from bifurcation to skull base), and dolichoarteriopathy type (tortuosity, coiling or kinking). Next, we investigated the association between cardiovascular risk factors and these measurements using linear and logistic regression analyses. Results The mean (standard deviation) length of the ICA was 93 (+/- 14) mm, with a median (interquartile range) TI of 1.2 (1.1-1.3). The overall prevalence of dolichoarteriopathies was 69%, with tortuosity being the most common (72%), followed by coiling (20%), and kinking (8%). We found that age and obesity were associated with a higher TI: difference per 10-year increase in age: 0.05 (95% confidence interval [CI] 0.02-0.08) and 0.16 (95% CI 0.07-0.25) for obesity. Obesity and hypercholesterolemia were associated with a more severe type of dolichoarteriopathy (odds ratio [OR] 2.07 [95% CI 1.04-4.12] and OR 2.17 [95% CI 1.02-4.63], respectively). Conclusion Dolichoarteriopathies in the extracranial ICA are common in patients with cerebrovascular symptoms, and age, obesity and hypercholesterolemia may play an important role in the pathophysiology of these abnormalities.

Original languageEnglish
Pages (from-to)3133-3138
Number of pages6
JournalEuropean Journal of Neurology
Issue number9
Publication statusPublished - Sept 2021


  • atherosclerosis
  • carotid disease
  • computed tomography angiography
  • stroke

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