Journal of Stroke and Cerebrovascular Diseases
Original ArticleRace-ethnic Variation in Carotid Bifurcation Geometry
Section snippets
Methods
We reviewed carotid bifurcation anatomy from all consecutive catheter cerebral angiograms requested by the neurologic service of a large community-based teaching hospital obtained during a 3-year period. Biplanar digital subtraction angiography was performed in all cases and printed images were reviewed. All cerebral angiograms were done by two angiographers using the same equipment thereby minimizing any differences in technique, image magnification, or projection angle.
The vascular anatomy
Results
A total of 153 cerebral angiograms were examined among 60 white, 48 Caribbean Hispanic, and 45 African American patients. The final analysis included 272 bifurcations of which 103 were among white, 87 Hispanic, and 82 African American patients.
The mean age of the population was 59.8 ± 15.8 years and 148 (54.4%) were men. Differences in clinical characteristics and vascular risk factors among racial groups are shown in Table 1. African Americans were younger than the other two groups and had a
Discussion
We found significant race-ethnic differences in the anatomy of the carotid bifurcation. African Americans have a proportionally smaller ICA and larger ECA than whites and Caribbean Hispanics.
It is generally thought that whites have an increased prevalence of extracranial atherosclerotic cerebrovascular disease than other race-ethnic groups. Several studies have reported a reduced prevalence of extracranial atheroma in blacks.10, 11, 12, 17 Such differences were originally reported by early
References (22)
- et al.
Distribution of fatty and fibrous plaques in young human coronary arteries
Atherosclerosis
(1982) - et al.
Relation between coronary artery geometry and the distribution of early sudanophilic lesions
Atherosclerosis
(1993) - et al.
Geometry of the human common carotid artery: A vessel cast study of 86 specimens
Pathol Res Pract
(2002) - et al.
Pathological-anatomical study concerning the geometry and atherosclerosis of the carotid bifurcation
Eur J Vasc Surg
(1990) - et al.
Black-white differences in subclinical cardiovascular disease among older adults: The cardiovascular health study; CHS collaborative research group
J Clin Epidemiol
(1995) - et al.
In vivo association between low wall shear stress and plaque in subjects with asymmetrical carotid atherosclerosis
Stroke
(1997) - et al.
Major variation in carotid bifurcation anatomy: A possible risk factor for plaque development?
Stroke
(2001) - et al.
Geometric factors of the bifurcation in carotid atherogenesis
Stroke
(1990) - et al.
Sex differences in carotid bifurcation anatomy and the distribution of atherosclerotic plaque
Stroke
(2001) - et al.
Arteriographic study of sites, incidence, and treatment of arteriosclerotic cerebrovascular lesions
Neurology
(1962)
Joint study of extracranial arterial occlusion, VI: Racial differences in hospitalized patients with ischemic stroke
JAMA
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