Abstract 2961: Basilar Artery Diameter Is Associated With The Severity Of Cerebral Small-vessel Disease In Patients With Vascular Risk Factors

Abstract

Background and purpose: Basilar arterial dolichoectasia (extreme enlargement and elongation) has been reported to be associated with cerebral small-vessel disease (CSVD) in stroke patients. The association of moderate dilatation of the basilar artery (BA) and CSVD or cerebrovascular risk factors is not clear. We analyzed BA diameter, stroke and white matter lesions, and other clinical factors in patients with atherosclerotic risk factors. Methods: The study subjects were 411 outpatients aged 50 or over who underwent brain magnetic resonance imaging (MRI) for clinical purposes. All patients had 1 or more atherosclerotic risk factors. The minor axis of the BA diameter was measured on the axial view of the T2-weighted MRI at midpons level. The location and size of the symptomatic and asymptomatic stroke lesions were evaluated. The severity of the deep white matter lesions were also assessed with Schelten’s score system by MRI. The anatomic variation in the posterior circle of Willis was assessed by MR angiography. Results: The diameter of BA was < 2.0 mm in 71 patients, 2.0 - 2.9 mm in 212 patients, 3.0 - 3.9 mm in 115 patients, 4.0 - 4.5 mm in 11 patients, and > 4.5 mm in 2 patients. In the univariate analysis, age, male gender, hypertension, low HDL cholesterol, the history of ischemic heart diseases, the presence of stroke lesions, and severity of deep white matter lesions were associated with BA diameter. Patients with infarctions ≤ 15 mm had larger size of BA than those with infarctions > 15 mm and those without infarctions. Patients with a bilateral adult-type posterior cerebral artery (PCA) had larger BA diameter than those with other types of PCA. In the multivariate regression analysis, male gender (P = 0.0002), the presence of stroke lesions (P = 0.009), severity of deep white matter lesions (P < 0.0001), and the variation in the posterior circle of Willis (P < 0.0001) were independently associated with BA diameter. Conclusion: BA diameter is associated with the severity of CSVD in high-risk patients. Dilatation process of BA and the development of CSVD may have common causes.