What question did this study set out to answer?

This research aims to explore the connection between carotid artery anatomy and the presence of white matter hyperintensities as a potential risk factor.

January 25, 2026Open Access

Relationship Between Carotid Artery Anatomy and Geometry and White Matter Hyperintensities and Accompanying Comorbid Factors

Key Result

Increased carotid bifurcation angle and higher ICA tortuosity index correlated with a higher risk of developing white matter hyperintensities (p < 0.001).

Key Points

This research aims to explore the connection between carotid artery anatomy and the presence of white matter hyperintensities as a potential risk factor.
Evaluated carotid artery geometry using three-dimensional models from computed tomography angiography (CTA) data.
Calculated vascular diameter, cross-sectional area, bifurcation angles, and ICA tortuosity index (TI).
Conducted multivariate regression analysis to identify risk factors associated with white matter hyperintensities.
Increased carotid bifurcation and ICA angles observed in the WMH group compared to the non-WMH group.
Higher ICA TI values were significant in the WMH group (p < 0.001).
Identified age, hypertension, and stroke history as independent risk factors for WMH (p < 0.05).
Correlations found between carotid angles and severity of WMH (p < 0.05).

Structured PICO

Are specific carotid artery anatomical and geometrical features associated with the presence and severity of white matter hyperintensities?

Population

Patients evaluated with computed tomography angiography (CTA) for carotid artery anatomy and geometry

Intervention

Measurement of carotid artery geometry (vascular diameter, cross-sectional area, carotid bifurcation and internal carotid artery [ICA] angles, ICA tortuosity index) using three-dimensional CTA models

Comparator

Patients without white matter hyperintensities (non-WMH group)

Outcome

Presence and severity of white matter hyperintensities (WMH)surrogate

Increased carotid bifurcation angle and internal carotid artery tortuosity are independent risk factors associated with the presence and severity of white matter hyperintensities.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background/Objectives: This study aimed to investigate the relationship between carotid artery anatomy and geometry and white matter hyperintensities (WMH) and to determine whether it is a risk factor for the disease. Methods: The geometry and anatomy of both carotid arteries were evaluated with the three-dimensional vessel model obtained from the computed tomography angiography (CTA) data, and the segmentation software calculated the geometrical features of the arteries. In this model, vascular diameter, vascular cross-sectional area, carotid bifurcation and internal carotid artery (ICA) angles, as well as ICA tortuosity index (TI) measurements of the common carotid artery (CCA) and ICA were determined. Results: Compared with the non-WMH group, increased carotid bifurcation and ICA angle and higher ICA TI values were found in the WMH group (p < 0.001). In multivariate regression analysis, increased carotid bifurcation angle, higher ICA TI values, age, hypertension, and stroke history were identified as independent risk factors for the development of WMH (p < 0.05). In addition, age, carotid bifurcation angles and ICA angles were found to be associated with the severity of WMH (p < 0.05). Conclusions: Considering the vascular pathologies involved in the pathogenesis of WMH, identifying these risk factors may help determine individuals who are at an increased risk.

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