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Nonatherosclerotic Pathology of the Neck Vessels: Prevalence and Flow Patterns

Division of Vascular Surgery, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, nlabrop{at}yahoo.com

Luis R. Leon, Jr, MD, RVT

Vascular Surgery Section, Southern Arizona Veterans Affairs Health Care System, Tucson, Arizona

Jose A. Gonzalez-Fajardo, MD

Division of Vascular Surgery, Loyola University Medical Center, Maywood, Illinois

Ashraf M. Mansour, MD

Division of Vascular Surgery, Loyola University Medical Center, Maywood, Illinois

Steven S. Kang, MD

Division of Vascular Surgery, Loyola University Medical Center, Maywood, Illinois

Objectives: To determine the prevalence and flow characteristics of nonatherosclerotic pathologies of the cervical vessels.

Design: From 1997 to 2003, 11 480 ultrasound tests were performed for neck vessel evaluation on patients with cerebrovascular symptoms and trauma, and on asymptomatic patients with a bruit, cervical mass, or prior to aortocoronary bypass. When necessary, these findings were confirmed by other imaging modalities.

Results: A total of 3010 repeated tests were excluded, leaving 8470 patients. The prevalence of nonatherosclerotic pathologies (n = 55) was 0.65%. The most common was thromboembolism (n = 19, 0.22%), followed by dissection (n = 16, 0.19%), carotid body tumors (n = 5, 0.06%), aneurysms (n = 4, 0.05%), fibromuscular dysplasia (n = 4, 0.05%), Takayasu's arteritis (n = 1, 0.01%), pseudoaneurysms (n = 5, 0.06%), and arteriovenous fistulae (n = 1, 0.01%). Cerebrovascular symptoms were present in 27 patients (49%).

Conclusion: Nonatherosclerotic pathology accounts for 0.65% of patients referred for neck vessel evaluation. About half of them are symptomatic. Diagnosis of these pathologies and knowledge of their flow characteristics is important for patient management.

Key Words: nonatherosclerotic pathology • carotid fibromuscular dysplasia • Takayasu's arteritis • carotid aneurysms • carotid body tumors

Vascular and Endovascular Surgery, Vol. 41, No. 5, 417-427 (2007)
DOI: 10.1177/1538574407303176


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