Clinical significance of the internal carotid artery angle in ischemic stroke

The carotid artery plays a major role in stroke aetiology and is a good indicator of atherosclerosis. However, the clinical significance of internal carotid artery (ICA) anatomy remains unclear in patients with ischaemic stroke. This study examined the relationship between ICA angle and risk of ischaemic stroke. ICA angles of patients with acute ischaemic stroke were retrospectively compared with those of control patients between March 2014 and July 2014. Controls consisted of those with headaches but without ischaemic stroke. In both groups, ICA angles were measured using Maximum Intensity Projection images from computed tomography angiography, and the relationship between ICA angle and risk of ischaemic stroke was analysed. Of 128 screened patients with acute ischaemic stroke, 27 were enrolled, and 29 with headache were enrolled as controls. No differences were found in baseline characteristics between the two groups, but intracranial stenosis was more frequent in patients with stroke than in controls. Bilateral ICA angles were significantly larger in patients with stroke than in controls. Multiple logistic regression models showed that the right ICA angle was associated with risk of ischaemic stroke. Measuring the ICA angle may help assess the risk of ischaemic stroke.