Geometrical characteristics associated with atherosclerotic disease in the basilar artery: a magnetic resonance vessel wall imaging study

Background: Vascular geometry may play an important role in the development of atherosclerosis. This study aimed to investigate the relationships between the geometrical characteristics of basilar artery (BA) and the presence, burden, and distribution of BA plaques using magnetic resonance vessel wall imaging. Methods: Patients with cerebrovascular symptoms in the posterior circulation were recruited and underwent magnetic resonance imaging. The BA's geometrical characteristics, including actual length, straightened length, tortuosity, lateral basilar artery-vertebral artery (VA) angle, lateral mid-BA angle, and BA convexity, were measured. The presence of plaques, stenosis, and plaque burden, including mean and maximal wall thickness, were evaluated. The BA's cross-sectional vessel wall was divided into 4 quadrants: dorsal, ventral, right, and left quadrant. The distribution of BA plaques was analyzed. Results: Of 344 recruited patients (mean age: 68.1 +/- 11.1 years; 200 males), 100 (29.1%) had BA plaques. Patients with BA plaques had higher tortuosity of the BA (13.6 +/- 9.0 vs. 9.7 +/- 7.7, P<0.001) compared to those without BA plaques. Multivariate regression analysis showed that tortuosity of the BA was associated with the presence of BA plaques (OR, 1.641; 95% CI, 1.232 to 2.186; P=0.001) and mean wall thickness (beta, 0.045; 95% CI, 0.008 to 0.081; P=0.017). The plaque distribution in the left wall and right wall of BA was more frequent in patients with right (P=0.006) and left (P<0.001) convex BA, respectively. Conclusions: The BA's geometrical characteristics, particularly tortuosity and convexity, are independently associated with the presence, burden, and distribution of plaques in the BA.

Automated summary

The geometrical characteristics of the basilar artery, especially tortuosity and convexity, are independently associated with the presence, burden, and distribution of plaques in the basilar artery.