Abstract
Abstract A048: De Novo Pseudoaneurysm Formation After Cervical Artery Dissection: Incidence, Risk Factors, and Outcomes
Stroke (1970), Vol.57(Suppl_1)
02/2026
DOI: 10.1161/str.57.suppl_1.A048
Abstract
Background: The clinical characteristics and complications associated with de novo pseudoaneurysm formation beyond the acute phase of cervical artery dissection remain poorly defined. In this study, we examined the incidence, risk factors, and related ischemic and hemorrhagic events of post-acute de novo pseudoaneurysm formation.
Methods: We analyzed data from the STOP-CAD study (Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection). A de novo pseudoaneurysm was defined as a new (not present on initial imaging) focal enlargement in the diameter of the artery, greater than the native lumen. The incidence of de novo pseudoaneurysm was assessed at 90 days, 180 days, and beyond 180 days of follow-up. Univariate and multivariate regression analyses were conducted to identify risk factors for post-acute de novo pseudoaneurysm formation. Kaplan-Meier survival estimates were used to compare ischemic and hemorrhagic events between patients with and without de novo pseudoaneurysms.
Results: Among 4008 patients, 546 were excluded as they had dissecting pseudoaneursyms on initial presentation. Therefore, 3,462 patients were included in this analysis of whom 220 patients (6.35%) developed a de novo pseudoaneurysm over a maximum follow-up of 4.4 years. Of these, 127 (57.72%) were detected within the first 90 days, and 172 (78.18%) within the first 180 days. In multivariate regression analyses, in addition to hypertension, active smoking and Hispanic ethnicity, fibromuscular dysplasia (FMD) was an independent risk factor for post-acute de novo pseudoaneurysm formation (adjusted OR: 2.160; 95% CI: 1.408-3.315; p < 0.001). Notably, the presence of a de novo pseudoaneurysm was not associated with a significant increase in ischemic (hazard ratio [HR] 1.43 [95% CI, 0.89-2.30]; P=0.14) or hemorrhagic events (hazard ratio [HR] 1.42 [95% CI, 0.43-4.69]; P=0.57).
Conclusion: De novo pseudoaneurysm formation following a diagnosis of a cervical artery dissection is not uncommon and most frequently occurs within the first 180 days. FMD was independently associated with this complication. The development of a de novo pseudoaneurysm did not significantly increase the risk of subsequent ischemic or hemorrhagic events.
Details
- Title: Subtitle
- Abstract A048: De Novo Pseudoaneurysm Formation After Cervical Artery Dissection: Incidence, Risk Factors, and Outcomes
- Creators
- Zafer Keser - Mayo ClinicMuhib Khan - Mayo ClinicThanh Nguyen - Boston UniversityElizabeth Lee - Brown UniversityLiqi Shu - Brown UniversityMelanie Ho - Brown UniversityPiers Klein - Boston UniversityDania Mallick - Rhode Island HospitalKim Griffin - University of Wisconsin–MadisonDaniel Mandel - United Hospital CenterRonen Leker - Hadassah Medical CenterIssa Metanis - Hadassah Medical CenterBalaji Krishnaiah - University of Tennessee at KnoxvilleSetareh Salehi Omran - University of Colorado DenverReza Bavarsad Shahripour - University of California San DiegoEkaterina Bakradze - University of Alabama at BirminghamNils Henninger - UMass Memorial Medical CenterStefan Engelter - University of BaselMirjam Heldner - University Hospital of BernKateryna Antonenko - University of BernJames Siegler - University of ChicagoJoao Pedro Marto - Hospital de Egas MonizAaron Rothstein - University of PennsylvaniaOssama Khazaal - Temple University HospitalChristian Nolte - Charité - Universitätsmedizin BerlinRoss Crandall - University of MinnesotaEvan Lester - Cornell UniversityAhmad Nehme - Normandie UniversitéBrian Mac Grory - Duke UniversityMohammad AlMajali - University of IowaMalik Ghannam - University of IowaAdeel Zubair - Yale UniversityMarwa Elnazeir - University of LouisvilleSami Al Kasab - Medical University of South CarolinaSyed Daniyal Asad - Hartford HospitalAnvesh Balabhadra - The University of Texas Health Science Center at HoustonAna Catarina Fonseca - Hospital de Santa MariaMichele Romoli - Ospedale “M. Bufalini” di CesenaDiana Cruz - Ospedale “M. Bufalini” di CesenaFaddi Saleh Velez - University of OklahomaAlexis Simpkins - Cedars-Sinai Medical CenterShayak Sen - Cedars-Sinai Medical CenterZedde Marialuisa - Azienda Sanitaria Unità Locale di Reggio EmiliaEdgar Samaniego - University of IowaChristoph Stretz - Brown UniversityWayneho Kam - Duke UniversityMohamad AbdalKader - Boston UniversityShadi Yaghi - Brown University
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.57(Suppl_1)
- DOI
- 10.1161/str.57.suppl_1.A048
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Publisher
- Lippincott Williams & Wilkins
- Language
- English
- Date published
- 02/2026
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9985132079802771
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