Сommon carotid artery elasticity in patients with cervical artery dissection

The purpose of the work is to study the state of the elastic properties of the common carotid artery wall (CCA) in patients with dissection of the internal carotid artery (ICA) and/or vertebral (VA) artery by means of the ultrasonography research.

Materials and methods 51 patients were examined (average age 38,4 ± 7,1 years old, 69% of them were women, undergone dissection of the ICA and/or VA. Control group: 51 healthy volunteers. Ultrasonography research with the assessment of the elastic properties of CCA (distensibility coefficient, arterial stiffness coefficient, Young’s modulus) was performed for all patients and healthy individuals.

Results. In patients with dissection, compared to the control group, the following characteristics were revealed: a decrease in CCA distensibility coefficient (23,08 [19,6; 26,2] 10–3  kPa–1  vs 29,6 [27,4; 31,7] 10–3  kPa–1, p < 0,0005), an increase in stiffness index β (6,5 [5,8; 7,4] vs 5,4 [4,9; 5,7], p < 0,0005), an increase in Young’s modulus, characterizing the elastic properties of the arterial wall’s material (49,9 [36,5; 56,4] kPa/mm vs 35,4 [30,0; 41,3] kPa/mm, p < 0,0004). It was higher in patients with FA, i.e. functional apoplexy (56 [38,9; 66,1] kPa/mm), compaired to patients with isolated neck pain/ headache (42,6 [36,3; 56,8] kPa/mm, p = 0,019); it increased with age (R = 0,352, p = 0,011) and due to the increase in cholesterol level (R = 0,330, p = 0,019). In patients with arterial hypotension, Young’s modulus was lower than that of normotonics (38,2 [32,5; 51,2] kPa/mm against (48,9 [42,5; 60,5] kPa/mm (p = 0,021). The stiffness index β was higher in patients examined during the first 3 months of the disease (7,1 [6,3; 7,6]) than in those examined later — (6,2 [5,4; 6,6], p = 0,036).

Conclusion.  Change in biomechanical  properties of the CCA wall in patients, undergone the ICA/VA dissection, indicates its increased rigidity. The presence of increased rigidity in the ICA/VA wall is also assumed, which predisposes to their dissection. Revealed correlations between parameters of biomechanical properties of CCA and clinical data explain some features of the clinical manifestations of dissection and its course.

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