Anatomical Relationship Between Carotid Artery and Hyoid Bone in Stenotic and Non-stenotic Carotids

Completed

• Conditions: Stenoses, Carotid; Stroke
• Interventions: Other: None, pure observational study

• Registration Number: NCT05349526
• Lead Sponsor: Centre Hospitalier Universitaire de Nīmes

Brief Summary

Ischaemic stroke is attributable to thromboembolism caused by carotid atherosclerotic disease in 18-25% of patients. Guidelines for prevention of stroke (especially carotid endarterectomy) in patients with carotid atherosclerotic plaque are based on the quantification of the degree of stenosis.

The hyoid bone, in proximity to the carotid artery, has been implicated in the pathophysiology of carotid artery dissection, atherosclerotic carotid disease, and compressive syndromes. In atherosclerotic carotid disease, pressure on the carotid artery induced by these bone structures has been proposed to play a possible role in plaque formation and rupture, leading to stenosis, occlusion, or artery-to-artery embolism. In a recent ultrasound study, dynamic displacement of the carotid artery with interference of the hyoid bone during swallowing, named as "flip-flop" phenomenon (FFP) has been associated with carotid artery stenosis and stenosis-related stroke. Another study based on CTA assessment observed no association between hyoid-carotid distance and plaque thickness, stenosis, or progression of thickness/stenosis. In that study, in almost two-third of the patients CTA was performed for stroke/transient ischemic attack work-up, including a vast majority of patients with absence of carotid stenosis (median degree of carotid stenosis was 7%), and plaque-related stroke was not assessed.

The objective of this study is to determine the anatomic hyoid-carotid interaction (ie, hyoid-carotid distance, carotid position relative to the hyoid bone, and hyoid morphology) based on CTA and its relation to the degree of carotid stenosis and stenosis-related stroke.

Detailed Description

Not available

Study Timeline

• Study Start: 2022-02-15
• Study First Submitted: 2022-04-21
• Study First Submitted QC: 2022-04-21
• Study First Posted: 2022-04-27
• Primary Completion: 2022-08-16
• Study Completion: 2022-08-16
• Status Verified: 2023-05
• Last Update Submitted: 2023-05-03
• Last Update Posted: 2023-05-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 206

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
non stenotic carotid	None, pure observational study	patients with non stenotic carotid
stenotic carotid	None, pure observational study	patients with a stenotic carotid

Primary Outcome Measures

Name	Time	Method
Carotid artery position in regard to ipsilateral greater horn of the hyoid	Base line, Day 0	The position of the carotid artery in regard to the ipsilateral greater horn of the hyoid (expressed in angle degree, with 0 to 90° corresponding to the posterolateral carotid position, 90 to 180° to anterolateral, 0 to -90° to posteromedial position, and -90 to-180° to anteromedial carotid position)
Distance hyoid-carotid artery	Base line, Day 0	the closest distance between the hyoid bone and the outer vessel wall of the carotid artery(mm)
Carotid artery portion closest to the hyoid bone	Base line, Day 0	Depending on the level of the carotid bifurcation: common carotid artery \[CCA\], carotid bifurcation \[CB\], or internal carotid artery \[ICA\])
Hyoid bone morphology	base line, day 0	Hyoid width (HW), hyoid length (HL), and hyoid circumferential length (HCL)

Trial Locations

Locations (1)

CHU de Nîmes; 🇫🇷 Nîmes, France