Journal article
Dissecting Aneurysm in Cervical Artery Dissection: Insights from the STOP-CAD Study
Stroke (1970)
01/29/2026
DOI: 10.1161/STROKEAHA.125.054847
PMID: 41608793
Abstract
Cervical artery dissection (CeAD) may result in dissecting aneurysm (DA) formation. We aimed to characterize risk factors and clinical outcomes associated with DA in a large, international CeAD cohort.
We performed a secondary analysis of the Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection (STOP-CAD), an international, multicenter, retrospective cohort. Patients with spontaneous CeAD were assessed for DA at baseline and de novo DA formation. Significant covariables in univariable analysis were included in multivariable regression models aiming to identify factors associated with DA formation. Logistic regression and Cox proportional hazards models evaluated the association of DA with ischemic and hemorrhagic outcomes.
Among 4,008 patients with CeAD, 546 (13.6%) had a DA at baseline, and 221/2938 (7.5%) patients developed a de novo DA during follow up, of which 172/221 (78.2%) were detected in the first 180 days. Patient with DA had a mean age of 47 years and 383 (49.9%) were women. Baseline or de novo DA was associated with history of connective tissue disorder (adjusted odds ratio [aOR] 2.02; 95% CI, 1.22-3.36), fibromuscular dysplasia (aOR 1.69; 95% CI, 1.28-2.25) and multiple vessel dissection (aOR 1.53, 95% CI 1.19-1.98). Lower odds of DA was seen in Hispanic ethnicity (aOR 0.64, 95% CI 0.43-0.97) and ischemic stroke presentation (aOR 0.41, 95% CI 0.34-0.49). Fibromuscular dysplasia was associated with de novo DA formation (aOR 2.30; 95% CI, 1.52-3.49). DA was not associated with ischemic stroke (Hazard ratio [HR], 0.71; 95% CI, 0.44-1.16; p=0.173) or intracranial hemorrhage (ICH) (HR 1.09; 95% CI, 0.42-2.84; P=0.86) by day 180.
DAs are relatively common manifestations of CeAD, typically occurring within six months of CeAD diagnosis. DA was not associated with an increased risk of subsequent ischemic stroke or ICH.
Details
- Title: Subtitle
- Dissecting Aneurysm in Cervical Artery Dissection: Insights from the STOP-CAD Study
- Creators
- Muhib Khan - Mayo ClinicZafer Keser - Mayo ClinicLiqi Shu - Brown UniversityElizabeth M Lee - Brown UniversityMelanie Ho - Brown UniversityPiers Klein - Boston UniversityDania Mallick - University of PennsylvaniaKim J Griffin - University of Wisconsin–MadisonDaniel M Mandel - West Virginia UniversityRonen R Leker - Hadassah Medical CenterIssa Metanis - Hadassah Medical CenterBalaji Krishnaiah - Neurology, University of Tennnessee Health Science Center, UNITED STATESSetareh Salehi Omran - University of Colorado DenverReza Bavarsad Shahripour - Saint John's Health CenterEkaterina Bakradze - University of Alabama at BirminghamNils Henninger - University of Massachusetts Chan Medical SchoolStefan T Engelter - University Hospital of BaselMirjam R Heldner - University of BernKateryna Antonenko - University Hospital of BernJames E Siegler - University of ChicagoJoão Pedro Marto - Hospital de Egas MonizAaron Rothstein - University of PennsylvaniaOssama Khazaal - Hospital of the University of PennsylvaniaChristian H Nolte - Charité - Universitätsmedizin BerlinRoss Curtiss Crandall - Hennepin Healthcare Research InstituteEvan Lester - University of Colorado BoulderAhmad Nehme - University of OxfordBrian Mac Grory - Duke UniversityMalik Ghannam - University of IowaMohammad AlMajali - Mercy St. Vincent Medical CenterMarwa Elnazeir - University of LouisvilleSami Al Kasab - Medical University of South CarolinaSyed Daniyal Asad - Hartford HospitalAnvesh Balabhadra - Hartford HospitalAna Catarina Fonseca - University of LisbonDiana Cruz - Administração Regional de Saúde de Lisboa e Vale do TejoMichele Romoli - Ospedale “M. Bufalini” di CesenaFaddi Ghassan Saleh Velez - University of OklahomaAlexis N Simpkins - Cedars-Sinai Medical CenterShayak Sen - Cedars-Sinai Medical CenterMarialuisa Zedde - Azienda Sanitaria Unità Locale di Reggio EmiliaEdgar A Samaniego - University of IowaAdeel S Zubair - Yale UniversityChristoph Stretz - Brown UniversityWayneho Kam - Rex HospitalMohamad Abdalkader - Boston UniversityShadi Yaghi - Jersey Shore University Medical CenterThanh N Nguyen - Boston University
- Resource Type
- Journal article
- Publication Details
- Stroke (1970)
- DOI
- 10.1161/STROKEAHA.125.054847
- PMID
- 41608793
- ISSN
- 1524-4628
- eISSN
- 1524-4628
- Publisher
- American Heart Association
- Language
- English
- Electronic publication date
- 01/29/2026
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9985132079402771
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