title: Age and disease-related geometric and structural remodeling of the carotid artery.
abstract: BACKGROUND
  Carotid artery geometry has been suggested as a risk factor for atherosclerotic carotid artery disease (ACD). Although normal aging and development of disease can both lead to geometric changes in the artery, whether geometric changes in a given artery actually predispose to disease or are just a consequence of remodeling during aging is unclear. We investigated carotid artery geometric changes with aging to identify geometric features associated with the presence of ACD.
  
  
  METHODS
  Carotid artery geometry was quantified by measuring carotid artery diameter, tortuosity, and bifurcation angle using three-dimensional reconstructions of thin-section computed tomography angiography scans in 15 healthy individuals (average age, 43 ± 18 years; range, 15-64 years). The same geometric features were measured in 17 patients (68 ± 10 years old) with unilateral ACD. Geometric features associated with presence of ACD were determined by using the nondiseased contralateral carotid artery as an intrinsic control. Elastin-stained carotid arteries were analyzed to assess age-related structural changes in 12 deceased individuals.
  
  
  RESULTS
  Increases were noted in bulb diameter (0.64 mm), bifurcation angle (10°), and tortuosity of the common carotid (CCA; 0.03) and internal carotid arteries (ICA; 0.04) for every decade of life. Density and continuity of circumferential and longitudinal elastin in the CCA and ICA decreased with age. Compared with normal carotid arteries, those with ACD demonstrated larger bulb diameters (P = .001) but smaller bifurcation angles (P = .001). CCA tortuosity (P = .038) increased in ACD arteries compared with normal carotid arteries, but ICA tortuosity was decreased (P = .026).
  
  
  CONCLUSIONS
  With increasing age, bulb diameter, tortuosity, and bifurcation angle increases in carotid arteries. These geometric changes may be related to degradation and fragmentation of intramural elastin. Arteries with atherosclerotic occlusive disease demonstrate decreased ICA tortuosity and smaller bifurcation angles compared with nondiseased carotid arteries.
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, Neb. Electronic address: alexey.kamenskiy@unmc.edu.
authors.forename: Alexey V
authors.initials: AV
authors.lastname: Kamenskiy
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, Neb; Department of Surgery and VA Research Service, VA Nebraska-Western Iowa Health Care System, Omaha, Neb.
authors.forename: Iraklis I
authors.initials: II
authors.lastname: Pipinos
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, Neb.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Carson
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, Neb.
authors.forename: Jason N
authors.initials: JN
authors.lastname: MacTaggart
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, Neb.
authors.forename: B Timothy
authors.initials: BT
authors.lastname: Baxter
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002340:Carotid Artery Diseases / Q000473:pathology*; D017536:Carotid Artery, Common / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology; D004549:Elastin / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012307:Risk Factors; D066253:Vascular Remodeling / Q000502:physiology; D055815:Young Adult
chemical_list: D004549:Elastin