Dissecting Aneurysm in Cervical Artery Dissection: Insights From the STOP-CAD Study
Year: 2026
Type: article
Abstract: BACKGROUND: Cervical artery dissection (CeAD) may result in dissecting aneurysm (DA) formation. We aimed to characterize risk factors and clinical outcomes associated with DA in a large, international CeAD cohort. METHODS: We performed a secondary analysis of STOP-CAD (Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection), an international, multicenter, retrospective cohort. Patients with spontaneous CeAD were assessed for DA at baseline and de novo DA formation. Significant covariates in univariable analysis were included in multivariable regression models aiming to identify factors associated with DA formation. Logistic regression and Cox proportional hazards models evaluated the association of DA with ischemic and hemorrhagic outcomes. RESULTS: Among 4008 patients with CeAD, 546 (13.6%) had a DA at baseline, and 221/2938 (7.5%) patients developed a de novo DA during follow-up, of which 172/221 (78.2%) were detected in the first 180 days. Patients with DA had a mean age of 47 years, and 383 (49.9%) were women. Baseline or de novo DA was associated with a history of connective tissue disorder (adjusted odds ratio [aOR], 2.02 [95% CI, 1.22–3.36]), fibromuscular dysplasia (aOR, 1.69 [95% CI, 1.28–2.25]), and multiple vessel dissection (aOR, 1.53 [95% CI, 1.19–1.98]). Lower odds of DA were seen in Hispanic ethnicity (aOR, 0.64 [95% CI, 0.43–0.97]) and ischemic stroke presentation (aOR, 0.41 [95% CI, 0.34–0.49]). Fibromuscular dysplasia was associated with de novo DA formation (aOR, 2.30 [95% CI, 1.52–3.49]). DA was not associated with ischemic stroke (hazard ratio, 0.71 [95% CI, 0.44–1.16]; P =0.173) or intracranial hemorrhage (HR, 1.09 [95% CI, 0.42–2.84]; P =0.86) by day 180. CONCLUSIONS: DAs are relatively common manifestations of CeAD, typically occurring within 6 months of CeAD diagnosis. DA was not associated with an increased risk of subsequent ischemic stroke or intracranial hemorrhage.
Source: Stroke
Authors: Muhib Khan, Zafer Keser, Liqi Shu, Elizabeth Lee, Melanie Ho, Piers Klein, Dania Mallick, Kim Griffin, Daniel Mandel, Ronen R. Leker, Issa Metanis, Balaji Krishnaiah, Setareh Omran, Reza Bavarsad Shahripour, Ekaterina Bakradze, Nils Henninger, Stefan T. Engelter, Mirjam R. Heldner, Kateryna Antonenko, James E. Siegler, João Pedro Marto, Aaron Rothstein, Ossama Khazaal, Christian H. Nolte, Ross Crandall, Evan Lester, Ahmad Nehme, Brian Mac Grory, Malik Ghannam, Mohammad Almajali, Marwa Elnazeir, Sami Al Kasab, Daniyal Asad, Anvesh Balabhadra, Ana Catarina Fonseca, Diana Cruz, Michele Romoli, Faddi Saleh Velez, Alexis N. Simpkins, Shayak Sen, Marialuisa Zedde, Edgar A. Samaniego, Adeel Zubair, Christoph Stretz, Wayneho Kam, Mohamad Abdalkader, Shadi Yaghi, Thanh N. Nguyen
Institutions: Mayo Clinic, Brown University, Boston University, University of Pennsylvania, University of Wisconsin–Madison, West Virginia University, Hadassah Medical Center, University of Tennessee Health Science Center, University of Colorado Boulder, University of California San Diego, University of Alabama at Birmingham, University of Massachusetts Chan Medical School, University of Basel, University of Bern, University Hospital of Bern, University of Chicago, Hospital de Egas Moniz, Temple University, Charité - Universitätsmedizin Berlin, Cornell University, Centre Hospitalier Universitaire de Caen Normandie, Duke University, University of Iowa, University of Louisville, Medical University of South Carolina, Hartford Hospital, University of Lisbon, Ospedale “M. Bufalini” di Cesena, University of Oklahoma, Cedars-Sinai Medical Center, Azienda Sanitaria Unità Locale di Reggio Emilia, Yale University, University of North Carolina at Chapel Hill
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7126040710