| Sex differences in carotid bifurcation anatomy and the distribution of atherosclerotic plaque. | |
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MedLine Citation:
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PMID: 11441196 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Plaque formation at arterial bifurcations depends on vessel anatomy, particularly the relative sizes of the branches, and the ratio of the outflow to inflow area. The facts that carotid plaque is more common in men and that carotid bruits in the absence of stenosis are more frequent in women raise the possibility that there are sex differences in carotid bifurcation anatomy. We studied 5395 angiograms from the European Carotid Surgery Trial. METHODS: To minimize secondary changes we excluded angiograms with >/=50% stenosis and also studied vessels with no disease. We measured arterial diameters at disease-free points and calculated the following ratios: internal/common (ICA/CCA); external/common (ECA/CCA); internal/external (ICA/ECA) carotid arteries; carotid bulb/CCA; and outflow/inflow area. We related these to sex and also studied the distribution of plaque in the whole trial population. RESULTS: Among 2930 angiograms with <50% stenosis, the mean ICA/CCA ratio, ICA/ECA ratio, and outflow/inflow area ratio were larger in women than in men (all P<0.0001). The findings were similar in 622 bifurcations without atheroma. There were also differences in the distribution of plaque, with men more likely to have the maximum stenosis distal to the carotid bulb (odds ratio, 2.29; 95% CI, 1.33 to 4.01; P=0.001) and women more likely to have stenosis of the ECA (odds ratio, 1.54; 95% CI, 1.30 to 1.85; P<0.0001). CONCLUSIONS: Sex differences in carotid bifurcation anatomy are not limited to absolute vessel size. In addition, the outflow to inflow area ratio is bigger in women, and relative to the CCA and ECA, women have larger ICAs than men. Irrespective of whether these differences are congenital or acquired, they may partly explain the sex differences that we found in the distribution of plaque and the sex differences in the prevalence of carotid atheroma in the general population. |
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Authors:
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U G Schulz; P M Rothwell |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 32 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2001 Jul |
Date Detail:
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Created Date: 2001-07-06 Completed Date: 2001-08-23 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 1525-31 Citation Subset: IM |
Affiliation:
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Stroke Prevention Research Unit, Department of Clinical Neurology, Radcliffe Infirmary, Oxford, England. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anatomy, Cross-Sectional Arteriosclerosis / pathology*, radiography Carotid Artery, Common / anatomy & histology, pathology, radiography Carotid Sinus / anatomy & histology*, pathology, radiography Carotid Stenosis / pathology*, radiography Female Humans Male Middle Aged Sex Characteristics* Sex Factors* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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