OBJECTIVE: Basilar arterial (BA) dolichoectasia is associated with cerebral small-vessel disease and stroke. However, the association between moderate dilation of the BA and cerebral small-vessel disease or subsequent cardiovascular events remains unclear. This study aims to clarify the factors related to BA diameter and to clarify whether the BA diameter is an independent predictor of cardiovascular events. APPROACH AND RESULTS: The study subjects comprised 493 outpatients with atherosclerotic risk factors. BA diameter, lacunar infarct, severity of deep white matter hyperintensities, and intracranial steno-occlusive lesions were assessed with MRI and magnetic resonance angiography. Then, we prospectively evaluated the association between BA diameter and cardiovascular events. The BA diameter ranged from 1.1 to 5.2 mm, and only 0.8% of the patients had dolichoectasia. Male sex, the presence of lacunar infarcts, the severity of deep white matter hyperintensities, the fetal-type variation of the circle of Willis, and intracranial steno-occlusive lesions were independently associated with BA diameter. In the mean follow-up of 6.0 years, 91 patients developed cardiovascular events. BA diameter was independently associated with total cardiovascular events after adjusting for age, sex, and conventional risk factors (hazard ratio, 1.55 per 1 mm increase in BA diameter; P=0.009). CONCLUSIONS: Increased BA diameter within the normal range is related to both large-vessel disease and cerebral small-vessel disease, and it could be a new predictor of cardiovascular events.
OBJECTIVE: Basilar arterial (BA) dolichoectasia is associated with cerebral small-vessel disease and stroke. However, the association between moderate dilation of the BA and cerebral small-vessel disease or subsequent cardiovascular events remains unclear. This study aims to clarify the factors related to BA diameter and to clarify whether the BA diameter is an independent predictor of cardiovascular events. APPROACH AND RESULTS: The study subjects comprised 493 outpatients with atherosclerotic risk factors. BA diameter, lacunar infarct, severity of deep white matter hyperintensities, and intracranial steno-occlusive lesions were assessed with MRI and magnetic resonance angiography. Then, we prospectively evaluated the association between BA diameter and cardiovascular events. The BA diameter ranged from 1.1 to 5.2 mm, and only 0.8% of the patients had dolichoectasia. Male sex, the presence of lacunar infarcts, the severity of deep white matter hyperintensities, the fetal-type variation of the circle of Willis, and intracranial steno-occlusive lesions were independently associated with BA diameter. In the mean follow-up of 6.0 years, 91 patients developed cardiovascular events. BA diameter was independently associated with total cardiovascular events after adjusting for age, sex, and conventional risk factors (hazard ratio, 1.55 per 1 mm increase in BA diameter; P=0.009). CONCLUSIONS: Increased BA diameter within the normal range is related to both large-vessel disease and cerebral small-vessel disease, and it could be a new predictor of cardiovascular events.
Authors: Jose Gutierrez; Tatjana Rundek; Ken Cheung; Ahmet Bagci; Noam Alperin; Ralph L Sacco; Clinton B Wright; Mitchell S V Elkind; Marco R Di Tullio Journal: Cerebrovasc Dis Date: 2017-01-04 Impact factor: 2.762
Authors: Makoto Nakajima; Lesly A Pearce; Nobuyuki Ohara; Thalia S Field; Carlos Bazan; David C Anderson; Robert G Hart; Oscar R Benavente Journal: J Stroke Cerebrovasc Dis Date: 2015-03-25 Impact factor: 2.136
Authors: Setareh Salehi Omran; Farid Khasiyev; Cen Zhang; Tatjana Rundek; Ralph L Sacco; Clinton B Wright; Mitchell S V Elkind; Jose Gutierrez Journal: J Neuroimaging Date: 2022-01-26 Impact factor: 2.324
Authors: A Pichiecchio; S Sacco; P De Filippi; E Caverzasi; S Ravaglia; S Bastianello; C Danesino Journal: J Neurol Date: 2017-08-30 Impact factor: 4.849
Authors: Ye Qiao; Zeeshan Anwar; Jarunee Intrapiromkul; Li Liu; Steven R Zeiler; Richard Leigh; Yiyi Zhang; Eliseo Guallar; Bruce A Wasserman Journal: Stroke Date: 2016-01-07 Impact factor: 7.914
Authors: Jose Gutierrez; Ken Cheung; Ahmet Bagci; Tatjana Rundek; Noam Alperin; Ralph L Sacco; Clinton B Wright; Mitchell S V Elkind Journal: J Am Heart Assoc Date: 2015-08-06 Impact factor: 5.501