High incidence and clinical characteristics of fibromuscular dysplasia in patients with spontaneous cervical artery dissection: The ARCADIA-POL study

Vasc Med. 2019 Apr;24(2):112-119. doi: 10.1177/1358863X18811596. Epub 2019 Feb 10.

Abstract

The association between fibromuscular dysplasia (FMD) and spontaneous cervical artery dissection (SCeAD) has been recognized, but the available evidence on this relationship is scant. Therefore, the main goal of our study was to systematically evaluate FMD frequency, clinical characteristics and vascular bed involvement in patients with SCeAD. Among 230 patients referred to the ARCADIA-POL study, 43 patients (mean age 44.1 ± 8.9 years; 15 men and 28 women) with SCeAD were referred. Also, 135 patients with FMD were compared to patients with and without SCeAD. Patients underwent: ambulatory blood pressure measurements, biochemical evaluation, echocardiographic examination, and whole body computed tomographic angiography. FMD changes were found in 39.5% of patients with SCeAD. There were no differences in clinical characteristics between patients with SCeAD and FMD and those without FMD, except for a tendency towards a higher female ratio in SCeAD patients with FMD. There were no differences in other parameters describing target organ and SCeAD characteristics. Patients with SCeAD and FMD compared to those without SCeAD were characterized by a lower frequency of hypertension and a higher frequency of hyperlipidemia and history of contraceptive hormone use. Our study indicates a high incidence (39.5%) of FMD in subjects with SCeAD. Since there are no distinctive discriminating factors between patients with SCeAD and FMD and those without FMD, FMD should be suspected in all patients with SCeAD.

Keywords: cerebrovascular disease; cervical artery dissection; fibromuscular dysplasia (FMD); hypertension.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Pressure Monitoring, Ambulatory
  • Cervical Vertebrae / blood supply*
  • Comorbidity
  • Computed Tomography Angiography
  • Echocardiography
  • Female
  • Fibromuscular Dysplasia / diagnosis
  • Fibromuscular Dysplasia / epidemiology*
  • Fibromuscular Dysplasia / physiopathology
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Incidence
  • Male
  • Middle Aged
  • Poland / epidemiology
  • Prospective Studies
  • Risk Factors
  • Sex Factors
  • Vertebral Artery Dissection / diagnosis
  • Vertebral Artery Dissection / epidemiology*
  • Vertebral Artery Dissection / physiopathology
  • Whole Body Imaging