Abstract
Abstract DP029: Incidence, risk factors, aneurysm growth, and outcomes of cervical artery dissection patients with dissecting aneurysm: STOP-CAD subanalysis
Stroke (1970), Vol.57(Suppl_1), DP029
02/2026
DOI: 10.1161/str.57.suppl_1.DP029
Abstract
Background: Cervical artery dissection (CeAD) accounts for nearly 25% of all ischemic strokes in young adults. CeAD can lead to the development of dissecting aneurysms (DA). However, the incidence, risk factors and outcomes of CeAD patients with DA is not well established. This study aims to identify risk factors for developing DA, subsequent growth, and impact on patient outcomes.
Methods: This is a secondary analysis of the Antithrombotics for Stroke Prevention in Cervical Artery Dissection (STOP-CAD), a multicenter cross-sectional international retrospective study. CeAD patients were stratified for the presence of DA. We used multivariable regression to identify factors associated with DA. Patients with DA were further analyzed for DA growth. The primary outcome was ischemic stroke after CeAD+DA diagnosis. Secondary outcomes included ischemic stroke after CeAD+DA with DA growth. Multivariable logistic regression analysis was used to assess the association between DA and risk factors. We also performed univariate Cox regression and generated Kaplan-Meier survival curves comparing study outcomes based on presence of DA and subsequent growth.
Results: Of the 4023 patients included in the STOP-CAD study, 4008 were included in this analysis and 767 (19%) patients had DA (546 with DA on initial presentation). Patients with DA had a mean age of 46 [IQR 37-55] years and 50% (383) were women. In combined adjusted analyses, DA patients were more often non-Hispanic (aOR 0.63, 95% CI 0.41-0.94, p<0.02), more commonly had a history of migraine (aOR 1.27, 95% CI 1.01-1.59, p=0.037), connective tissue disorder (aOR 2.02, 95% CI 1.22-3.36, p=0.007), minor neck trauma (aOR 1.70, 95% CI 1.29-2.26, p<0.001) and were more likely to present with ischemic stroke (aOR 1.73, 95% CI 1.05-2.87, p=0.031). DA growth was noted in 55 out of 546 (10%) patients with DA on presentation. There was no significant difference in the risk of ischemic stroke by day 180 in patients with DA (hazard ratio [HR] 0.92 [95% CI, 0.65-1.30]; P=0.63) or DA growth (HR 2.40, [95% CI, 0.79-7.24]; P=0.12).
Conclusion: In this subanalysis of STOP-CAD, nearly one in five patients with CeAD developed a DA. Factors associated with a higher likelihood of DA included non-Hispanic ethnicity, history of migraine, connective tissue disorder, minor neck trauma, and ischemic stroke at presentation. DA diagnosis and DA growth did not impact the risk of subsequent ischemic stroke at 6 months.
Details
- Title: Subtitle
- Abstract DP029: Incidence, risk factors, aneurysm growth, and outcomes of cervical artery dissection patients with dissecting aneurysm: STOP-CAD subanalysis
- Creators
- Muhib Khan - Mayo ClinicZafer Keser - Mayo ClinicThanh Nguyen - Boston UniversityElizabeth Lee - Brown UniversityMelanie Ho - Brown UniversityLiqi Shu - Brown UniversityPiers Klein - Boston UniversityDania Mallick - Rhode Island HospitalKim Griffin - Cleveland ClinicDaniel Mandel - University of BridgeportRonen Leker - Hadassah Medical CenterIssa Metanis - Hadassah Medical CenterBalaji Krishnaiah - University of Tennessee Health Science CenterSetareh 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 BernAntonenko Katheryna - University Hospital 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 Colorado DenverEvan Lester - Cornell UniversityAhmad Nehme - Normandie UniversitéBrian MacGrory - Duke UniversityMalik Ghannam - University of IowaMohammad AlMajali - 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 - University of LisbonDiana Cruz - Hospital de Santa MariaMichele Romoli - Ospedale “M. Bufalini” di CesenaFaddi Saleh Velez - University of OklahomaAlexis Simpkins - Cedars-Sinai Medical CenterShayak Sen - Cedars-Sinai Medical CenterMarialuisa Zedde - Azienda Sanitaria Unità Locale di Reggio EmiliaEdgar Samaniego - University of IowaChristoph Stretz - Brown UniversityWayneho Kam - North Carolina State UniversityMohamad AbdalKader - Boston UniversityShadi Yaghi - Brown University
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.57(Suppl_1), DP029
- DOI
- 10.1161/str.57.suppl_1.DP029
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Publisher
- Lippincott Williams & Wilkins; PHILADELPHIA
- Language
- English
- Date published
- 02/2026
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9985132082302771
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