CLINICAL CHARACTERISTICS OF PATIENTS WITH SPONTANEOUS CERVICAL ARTERY DISSECTION - THE POLISH REGISTRY FOR FIBROMUSCULAR DYSPLASIA (ARCADIA-POL STUDY)

Abstract

Objective: To assess the clinical characteristics of patients with spontaneous cervical artery dissection enrolled into ARCADIA-POL study. Design and method: Out of 435 patients enrolled into ARCADIA-POL study since January 2015 (instituted on the basis of Polish-French collaboration) we present 77 consecutive patients with confirmed spontaneous cervical artery dissection (SCeAD) which was one of the inclusion criteria to the study. A standardized fibromuscular dysplasia (FMD) data form was used for data collection. All patients underwent detailed clinical evaluation including ABPM, biochemical evaluation, biobanking and imaging, duplex Doppler of carotid and abdominal arteries and whole body angio-CT. Results: In our analysis we included 77 patients with confirmed SCeAD (50F [64.9%], 27 M [35.1%], mean age: 43.9 +/- 9.6). Dissection involved internal carotid artery in 53 (68.8%) patients, vertebral artery in 19 (24.7%) patients and 5 (6.5%) patients presented coexisting vertebral and carotid artery dissection. FMD was confirmed in 27 (35.1%) patients – 22 of patients in one and in 5 patients in two or more vascular beds. Among patients with cervical artery dissection coexisting with FMD, the most frequent localization of FMD lesions were carotid arteries (66.7%) and renal arteries (44.4%) and subclavian artery in one patient. Hypertension was diagnosed in 59.7% of patients. 27 female patients (54%) confirmed usage of hormonal contraception agents in the medical history. The most frequent clinical symptoms associated with the occurrence of cervical artery dissection in the analyzed group were headaches (70.1%), vision disturbances (39%), dizziness (39%), eye pain (40%) and neck pain (37.7%). In 31 patients (40.3%) cervical artery dissection was associated with ischemic stroke and in 9 patients (11.7%) with transient ischemic attack. Conclusions: Systematic evaluation by means of whole-body angio-CT of patients with SCeAD confirmed FMD in 1 out of 3 patients. Our data confirms that FMD should be considered as systematic disease with clinical presentation ranging from asymptompatic changes to life-threatening conditions such as SCeAD.