Key result
Carotid bends, bifurcations, and wide apertures correlate with asymmetric atherosclerotic plaque formation.
Why the study?
Tortuosity and bifurcations in carotid arteries alter blood flow and cause atherosclerosis, prompting analysis of variant cervical vascular anatomy on atherosclerosis development by microanatomical examination.
Does variant carotid vascular anatomy (bends, bifurcations, and wider arterial apertures) promote the development of histologically verified atherosclerosis in human carotid arteries?
Case Report (n=1)
Does variant carotid vascular anatomy (bends, bifurcations, and wider arterial apertures) promote the development of histologically verified atherosclerosis in human carotid arteries?
Histological examination of a cadaveric carotid tree confirms hemodynamic model predictions that arterial bends, bifurcations, and wider vessel apertures reduce shear stress and flow velocity, localizing atherosclerotic plaque development.
Answers are grounded in this paper and cite their sources.
Cadaveric histology links variant carotid anatomy to plaque; hypothesis-generating for hemodynamic risk factors, not yet informing practice.
BACKGROUND: Tortuosity and bifurcations in carotid arteries alter the blood flow, causing atherosclerosis. OBJECTIVES: The aim of the present study is to analyze the effect of variant vascular anatomy in the cervical region on development of atherosclerosis by microanatomical examination. METHODS: The effect of blood flow at anomalous bends and bifurcations was observed in right carotid arteries of a seventy year old female cadaver. Fifteen histological slides were prepared from the carotid arteries and interpreted to verify predictions of atherosclerosis. RESULTS: The model predicts atherosclerosis at bends, bifurcations and large aperture arteries. Microanatomical examination revealed presence of atherosclerosis of varying thickness at the bends and bifurcation in the right carotid arteries, as predicted. Atherosclerosis was also detected in the straight part of the wider common carotid artery. No atherosclerosis was observed in the contralateral carotid arteries. The variant carotid vascular anatomy consisting of bends, bifurcations and wider arteries revealed that the shear stress and velocity of blood flow are reduced at these anomalous sites. CONCLUSIONS: Anatomical anomalies such as bends and branching in the carotid arteries alter the irrigation pattern and generate biomechanical forces that cause turbulent flow and reduce shear stress/blood flow velocity. Decreased shear stress and velocity causes development of atherosclerosis. Histological slides established the presence of atherosclerosis at bends and bifurcations and in wider arteries.
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Singh et al. (2018) conducted a case report in Carotid artery atherosclerosis and vascular tortuosity (n=1). Anatomical anomalies (bends, bifurcations, and wider arterial apertures) in the right carotid arteries vs. Straight, narrower arterial segments and contralateral carotid arteries was evaluated on Histological presence and thickness of atherosclerotic plaque. Anatomical bends, bifurcations, and wide apertures in the right carotid arteries exhibited atherosclerotic plaque thicknesses from 1 to 79 mm vs 0 mm in the contralateral arteries.
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