Clinical neuroradiology · 2026
Risk Factors for Morphological Progression of Vertebrobasilar Dolichoectasia During the Aging Process: a Magnetic Resonance Angiography Cohort Study.
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Xu Yuhan, Jin Zehui, Xie Chunming, Guo Yijing, Xie Jian
Аннотация
BACKGROUND: Vertebrobasilar dolichoectasia (VBD) has emerged as a significant vascular degenerative disorder in older population, but lacks effective prevention and treatment. We aimed to determine clinical features linked to VBD progression and identify risk factors for ischemic stroke in patients with VBD.
METHODS: This retrospective cohort study included 191 VBD patients with baseline and follow-up MRA. Vertebral/basilar artery (VA/BA) geometric parameters were quantified using 3D-Slicer, and VBD progression was defined by annual growth rates of BA parameters. Logistic regression identified factors associated with VBD progression or new-onset stroke, and independent predictors were incorporated into nomograms.
RESULTS: Over a median 7.7-year follow-up, 88 patients showed VBD progression. Logistic regression identified baseline age (OR = 0.91), diabetes (OR = 3.19), white matter hyperintensities (WMH) severity (OR = 1.70), and unilateral vertebral artery dominance (UVD) (OR = 5.53) as independent risk factors. Nontraditional factors associated with increased risk of subsequent posterior-circulation ischemic stroke in VBD patients were complex shapes of VBA (OR = 1.74) and VBD progression (OR = 2.47). Nomograms incorporating these factors demonstrated excellent discriminative performance for both outcomes.
CONCLUSION: This study suggests that young age, diabetes, severe WMH, and UVD are independent risk factors for rapid VBD progression, thereby further increasing the likelihood of ischemic stroke in posterior circulation territory. These findings highlight that managing modifiable factors in VBD progression may help to reduce the occurrence of ischemic stroke.
METHODS: This retrospective cohort study included 191 VBD patients with baseline and follow-up MRA. Vertebral/basilar artery (VA/BA) geometric parameters were quantified using 3D-Slicer, and VBD progression was defined by annual growth rates of BA parameters. Logistic regression identified factors associated with VBD progression or new-onset stroke, and independent predictors were incorporated into nomograms.
RESULTS: Over a median 7.7-year follow-up, 88 patients showed VBD progression. Logistic regression identified baseline age (OR = 0.91), diabetes (OR = 3.19), white matter hyperintensities (WMH) severity (OR = 1.70), and unilateral vertebral artery dominance (UVD) (OR = 5.53) as independent risk factors. Nontraditional factors associated with increased risk of subsequent posterior-circulation ischemic stroke in VBD patients were complex shapes of VBA (OR = 1.74) and VBD progression (OR = 2.47). Nomograms incorporating these factors demonstrated excellent discriminative performance for both outcomes.
CONCLUSION: This study suggests that young age, diabetes, severe WMH, and UVD are independent risk factors for rapid VBD progression, thereby further increasing the likelihood of ischemic stroke in posterior circulation territory. These findings highlight that managing modifiable factors in VBD progression may help to reduce the occurrence of ischemic stroke.