Edorium Journal of

Cardiology

 
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Original Article
 
Vascular profile of dolichoectasia differs depending on the presenting symptoms
Jose Gutierrez1, Jennifer Carrasquillo2, Gustavo Ortiz3, Clinton B Wright4
1MD, MPH, Assistant Professor of Neurology, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
2MD, Postdoctoral fellow, Evelyn F. McKnight Brain Institute, Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, USA.
3MD, Assistant Professor of Neurology, Evelyn F. McKnight Brain Institute, Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, USA.
4MD, MS, Associate Professor of Neurology, Departments of Neurology and Epidemiology and Public Health, Leonard M. Miller School of Medicine, University of Miami, USA.

Article ID: 100001C03JG2014
doi:10.5348/c03-2014-1-OA-1

Address correspondence to:
Jose Gutierrez
710 West 168th Street
6th Floor, New York
NY 10032-3784
USA
Phone: (212) 305-1353
Email: jg3233@cumc.columbia.edu

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How to cite this article
Gutierrez J, Carrasquillo J, Ortiz G, Wright CB. Vascular profile of dolichoectasia differs depending on the presenting symptoms. Edorium J Cardiol 2014;1:1–10.


Abstract
Aims: To evaluate the cardiovascular profile of patients with dolichoectasia and compressive versus vascular symptoms.
Methods: We diagnosed patients with dolichoectasia in a hospital-based practice and used Smoker's and Ubogu's criteria to define dolichoectasia of the basilar artery and vertebral arteries, respectively. For the anterior circulation and the posterior cerebral artery, we used two-featured criteria for dolichoectasia consisting of compression of the parenchyma and an aberrant pathway.
Results: We identified 18 patients with dolichoectasia of at least one intracranial artery (mean age 56 years, median 61 years, range 32–90 years; eight patients were women, nine patients were Hispanic whites, eight were blacks, and one was white). Two out of three patients who presented with compressive symptoms attributed to dolichoectasia did not have any cardiovascular risk factors. Ten patients presented with vascular symptoms. Six of these patients were men and four were women. Excluding patients with HIV, the remaining six patients with vascular symptoms had a greater number of cardiovascular risk factors (1 to 7 risks) when compared with the group with isolated compressive symptoms (0 to 3 risks). The most affected vessels were the basilar and vertebral arteries, followed by the internal carotid and anterior cerebral arteries.
Conclusion: Dolichoectasia and cardiovascular symptoms are more often found in patients who present with vascular symptoms while patients with compression symptoms less frequently have cardiovascular risk factors. The mechanism underlying dolichoectasia in patients with compressive symptoms need to be further investigated.

Keywords: Dolichoectasia, Arterial tortuosity, Vascular remodeling, Fusiform aneurysm, Arteriopathy

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Author Contributions:
Jose Gutierrez – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Jennifer Carrasquillo – Acquisition of data, Critical revision of the article, Final approval of the version to be published
Gustavo Ortiz – Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published
Clinton B Wright – Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2014 Jose Gutierrez et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



About The Authors

Gutierrez's main research interest is brain arterial remodeling and its association/risks with cerebrovascular disease, including stroke and vascular dementia. His projects have specifically focused on HIV and the mechanism underlying the arteriopathy sometimes seen in HIV, consisting of arterial dilatation and subsequent strokes. Dr. Gutierrez is the leader of one of the largest postmortem brain large arteries studies from which morphometric and functional characterization has been carried over. Additionally, he has dedicated a fair amount of time to collecting brain arterial diameters in more than 700 stroke-free subjects from the Northern Manhattan Study (NOMAS), to further investigate the associations and consequences of brain arterial remodeling. Dr. Gutierrez's other areas of interest include disparities in stroke mechanisms and stroke prevention.




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