ArticleQuantitative imaging in medicine and surgery2026
Age-related geometric analysis of the extracranial artery for endovascular access planning.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Age-related geometric remodeling of the extracranial carotid arteries significantly influences hemodynamics and endovascular accessibility, yet comprehensive data covering the entire supra-aortic route remain limited. The objective of this study was to investigate these age-related geometric changes from the aortic arch to the proximal internal carotid artery (ICA) using computed tomography angiography (CTA), and to assess their association with vascular aging. Methods: This retrospective cross-sectional study included 485 patients who underwent CTA between January 2020 and December 2022. The participants were divided into two age groups: young (<60 years) and old (>70 years). Patients with carotid plaques or stenosis were excluded. Using semi-automated segmentation techniques, we analyzed geometric parameters, including vascular tortuosity, maximal diameter, cross-sectional area, and bifurcation angles from the aortic arch to the proximal ICA. Results: Out of the 485 participants, 257 (53%) were included in the old age group (mean age: 78.77±0.36 years). Vascular tortuosity from the common carotid artery (CCA) to the carotid artery bifurcation (CAB) was significantly higher in the old age group on both sides (right: 0.15±0.01 Conclusions: Geometric changes in extracranial carotid arteries, including increased tortuosity, diameter, cross-sectional area, and bifurcation angle, are strongly associated with aging. These findings highlight the potential of CTA-based vascular geometry as a non-invasive imaging biomarker for assessing vascular aging and early structural remodeling.
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