Associations between atherosclerotic luminal stenosis in the distal internal carotid artery and diffuse wall thickening in its upstream segment

Motivation: Significant atherosclerotic stenosis or occlusion in the distal carotid artery may induce diffuse wall thickening (DWT) in the upstream arterial wall. Goal(s): This study aimed to assess the association of atherosclerotic steno-occlusive diseases in the distal internal carotid artery (ICA) with DWT in the upstream ipsilateral ICA. Approach: Individuals with atherosclerotic stenosis in the distal ICA, detected by carotid MR vessel wall imaging, were enrolled. Results: Significant correlations were found between distal ICA stenosis and DWT in the petrous ICA, DWT severity, the longitudinal extent of DWT in the ICA, enhancement in the petrous ICA) and enhancement degree. Impact: Diffuse wall thickening is a common secondary change in atherosclerotic steno-occlusive disease in the intracranial carotid. This phenomenon constitutes a confounding factor in the distinction between atherosclerosis and inflammatory vasculopathies, and could be reversed after alleviated atherosclerotic stenosis.