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

NCT05349526 | Completed

• 1 other identifier: Local/2022/DR-01
• Study Type: observational
• Target: 206
• Locations: 1 country
• Sites: 1

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.

Conditions

Stenoses, Carotid; Stroke

Keywords

computed tomography; carotid; atherosclerotic; plaque; density; stroke

Outcome Measures

Primary Outcomes (4)

• Distance hyoid-carotid artery

  the closest distance between the hyoid bone and the outer vessel wall of the carotid artery(mm)

  Base line, Day 0

• Carotid artery portion closest to the hyoid bone

  Depending on the level of the carotid bifurcation: common carotid artery \[CCA\], carotid bifurcation \[CB\], or internal carotid artery \[ICA\])

  Base line, Day 0

• Carotid artery position in regard to ipsilateral greater horn of the hyoid

  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)

  Base line, Day 0

• Hyoid bone morphology

  Hyoid width (HW), hyoid length (HL), and hyoid circumferential length (HCL)

  base line, day 0

Study Arms (2)

stenotic carotid

patients with a stenotic carotid

Other: None, pure observational study

non stenotic carotid

patients with non stenotic carotid

Other: None, pure observational study

Interventions

None, pure observational study OTHER

None, pure observational study

non stenotic carotid; stenotic carotid

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Retrospective analysis of preoperative CTA of 206 consecutive adult patients (\>18 years of age) who underwent carotid endarterectomy for symptomatic or asymptomatic stenosis, registered in the stroke database between November 2016 and March 2020 in Nîmes University Hospital (France).

* Patients followed at the University Hospital of Nîmes between November 2016 and March 2020 * Age \> 18 years * Patients who underwent carotid endarterectomy for symptomatic or asymptomatic stenosis

Contact the study team to discuss eligibility requirements. They can help determine if this study is right for you.

Sponsors & Collaborators

• Centre Hospitalier Universitaire de Nīmes: lead

Study Sites (1)

CHU de Nîmes

Nîmes, 30029, France

Location

Related Publications (1)

• Salaun-Penquer E, Laurent-Chabalier S, Trandafir C, Cosma C, Parvu T, Wacongne A, Thouvenot E, Renard D. Relationship between hyoid-carotid distance, hyoid position and morphology and degree of stenosis and associated stroke: Hyoid-carotid relationship. J Stroke Cerebrovasc Dis. 2025 Jan;34(1):108106. doi: 10.1016/j.jstrokecerebrovasdis.2024.108106. Epub 2024 Nov 19.

  PMID: 39571666 RESULT

MeSH Terms

Conditions

Carotid Stenosis; Stroke; Plaque, Amyloid

Condition Hierarchy (Ancestors)

Carotid Artery Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Arterial Occlusive Diseases; Vascular Diseases; Cardiovascular Diseases; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms

Study Officials

• Anissa MEGZARI

  Centre Hospitalier Universitaire de Nīmes

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 21, 2022
• First Posted: April 27, 2022
• Study Start: February 15, 2022
• Primary Completion: August 15, 2022
• Study Completion: August 15, 2022
• Last Updated: December 4, 2025

Record last verified: 2023-05

Locations

FR (1)