Correlation between vertebral artery tortuosity and posterior circulation ischemia / 国际脑血管病杂志

ABSTRACT

Objective To investigate the correlation between vertebral artery tortuosity and posterior circulation ischemia (PCI). Methods The patients with PCI aged ≥50 years old and the controls without PCI at the same time were enrolled. CT angiography was performed in all patients. The cervical vertebral artery tortuosity was observed and rated, and the related risk factors for influencing PCI were analyzed. Results A total of 112 patients with PCI and 90 controls were enrolled. Univariate analysis showed that the proportions of patients with hypertension (80. 36% vs. 54. 44% ; χ2 = 15. 613, P < 0. 001), smoking (35. 71% vs. 18. 89% ; χ2 = 6. 974, P = 0. 008), alcohol consumption (25. 89% vs. 10. 00% ; χ2 = 8. 253, P = 0. 004), posterior circulation vascular stenosis (54. 46% vs. 24. 44% ; χ2 = 18. 578, P < 0. 001), and vertebral artery tortuosity (71. 43% vs. 48. 89% ; χ2 = 10. 695, P = 0. 001), as well as the levels of the total cholesterol (4. 96 ± 1. 26 mmol/L vs. 4. 61 ± 1. 04 mmol/L; t = - 2. 110, P = 0. 036 ), low-density lipoprotein cholesterol (3. 02 ± 0. 90 mmol/L vs. 2. 69 ± 0. 78 mmol/L; t = - 2. 671, P = 0. 008 ), and fibrinogen (3. 67 ± 1. 69 mg/L vs. 3. 25 ± 0. 97 mg/L; t = - 2. 002, P = 0. 047) in the PCI group were significantly higher than those in the control group. The proportion of bilateral vertebral artery tortuosity in the PCI group was significantly higher that in the control group (30. 36% vs. 12. 22% ; χ2 = 9. 478, P =0. 002). The proportion of grade 3 vertebral artery tortuosity in the PCI group was significantly higher than that in the control group (43. 75% vs. 26. 67% ; χ2 = 6. 310, P = 0. 012). Multivariate logistic regression analysis showed that smoking (odds ratio [OR] 2. 339, 95% confidence interval [CI] 1. 037-5. 278; P =0. 041), low-density lipoprotein cholesterol (OR 1. 580,95% CI 1. 050-2. 377; P = 0. 028), hypertension (OR 2. 631, 95% CI 1. 237-5. 596; P = 0. 012), posterior circulation vascular stenosis (OR 3. 419, 95% CI 1. 638-7. 134; P = 0. 001), and vertebral artery tortuosity (OR 2. 413, 95% CI 1. 212-4. 803; P = 0. 012) were the independent risk factors for PCI. Conclusion The vertebral artery tortuosity is an independent risk factor for PCI in the middle-aged and elderly people.