Geometric classification of the carotid siphon: Association between geometry and stenoses

Purpose: The development of intracranial internal carotid artery (ICA) stenoses may be associated with the morphology of the siphon. The aim is to quantitatively characterize the geometry of ICA, and develop a classifier of the ICA shape in relation to the location and incidence of stenoses. Methods: The ICA geometry from 74 subjects was analyzed by means of image-based computational techniques. The siphon was split into two bends, and was described in terms of curvature radius, radius of vessel, angle of bending, and length. Differences of geometry between ICA classes were assessed in control group, consisted of 30 subjects without stenoses. In stenosed group, the association between the ICA classes and the incidence of stenoses were investigated and validated by hemodynamic simulation. Results: The curvature radius and angle of the posterior bend were significantly different between ICA classes, as well as the angle between the two bends. An innovative classifier was developed with the three geometric parameters. The ICA classification was found associated with the incidence of stenoses at the siphon. Conclusions: Geometric factors relative to the ICA were correlated with the location and incidence of stenoses at the siphon. The present work has potential implications in the quest for hemodynamic factors contributing to the initiation and progression of intracranial ICA stenoses.