Relationship Between Carotid Artery Anatomy and Geometry and White Matter Hyperintensities and Accompanying Comorbid Factors

Abstract

Background/Objectives: This study aimed to investigate the relationship between carotid artery anatomy and geometry and white matter hyperintensities (WMH) and to determine whether it is a risk factor for the disease. Methods: The geometry and anatomy of both carotid arteries were evaluated with the three-dimensional vessel model obtained from the computed tomography angiography (CTA) data, and the segmentation software calculated the geometrical features of the arteries. In this model, vascular diameter, vascular cross-sectional area, carotid bifurcation and internal carotid artery (ICA) angles, as well as ICA tortuosity index (TI) measurements of the common carotid artery (CCA) and ICA were determined. Results: Compared with the non-WMH group, increased carotid bifurcation and ICA angle and higher ICA TI values were found in the WMH group (p < 0.001). In multivariate regression analysis, increased carotid bifurcation angle, higher ICA TI values, age, hypertension, and stroke history were identified as independent risk factors for the development of WMH (p < 0.05). In addition, age, carotid bifurcation angles and ICA angles were found to be associated with the severity of WMH (p < 0.05). Conclusions: Considering the vascular pathologies involved in the pathogenesis of WMH, identifying these risk factors may help determine individuals who are at an increased risk.