Use of Carotid Web Angioarchitecture for Stroke Risk Assessment

Abstract

To examine the utility of carotid web (CW), carotid bifurcation, and their combined angioarchitectural measurements in assessing stroke risk. Anatomical data of the internal carotid artery (ICA), common carotid artery (CCA), and the CW was gathered as part of a retrospective study from symptomatic (stroke) and asymptomatic (non-stroke) patients with CW. We built a model of stroke risk using principal-component analysis, Firth regression trained with 5-fold cross-validation, and heuristic binary cutoffs based on Minimal Description Length principle. The study included 22 patients with a mean age of 55.9 ± 12.8 years and 72.9% being female. Eleven patients experienced an ischemic stroke. The first two principal components distinguished between stroke patients and non-stroke patients. The model revealed that ICA Pouch-Tip angle (p= 0.036), CCA Pouch-Tip angle (p= 0.036), ICA Web-Pouch angle (p= 0.036), and CCA Web-Pouch angle (p= 0.036) are the most important features associated with stroke risk. Conversely, CCA and ICA anatomy (diameter and angle) were not found to be risk factors. This pilot study demonstrates that using data from CT angiogram, carotid bifurcation, and CW angioarchitecture may be used to assess stroke risk, allowing physicians to tailor care for each patient according to risk stratification.