To investigate the impact of the common carotid artery bifurcation angle on dementia, stroke or cardiovascular disease, and cancer risk as a cause of death.

Common carotid artery (CCA) bifurcation geometry has been shown to play a role in atherosclerotic risk, which has known correlations to stroke, dementia, and cancer pathophysiologies. We aimed to identify correlations between CCA bifurcation angle and cause of death (COD) in a cadaveric population.

An observational study assessed a population of 28 cadavers (age range = 57-95) via dissection. After exposing the carotid artery, angle of bifurcation (BA, angle between ECA and ICA) was measured with a digital caliper and protractor. Bifurcation data was then run against COD, which included dementia, stroke/cardiovascular events, and cancer, to identify any potential correlations.

There was a significant positive relationship between left CCA angle and dementia as a cause of death (p=0.027) and a trending significance between dementia and mean right CCA angle at the 10% significance level (p=0.096). No significant correlations were found between mean bifurcation angle and stroke/cardiovascular (left CCA, p=0.51; right CCA, p=0.86) or cancer (left CCA, p=0.45; right CCA, p=0.64) as a COD. 

Larger common carotid angle has a significant positive correlation to dementia morbidity risk. Our results suggest that carotid bifurcation angle, particularly on the left, plays a role in dementia pathophysiology and progression. We endorse further studies utilizing larger samples and in vivo imaging to better explore the mechanisms and predictive value of CCA geometry in neurovascular and neurodegenerative conditions.