Abstract #2795

Quantification of Cerebrovascular Tortuosity of the SCD Patients using Angiography

Shayan Farzad¹, Adam Bush², Damini Dey³, Natasha Lepore⁴, Thomas Coates⁵, John Wood⁶, Julie Coloigner⁴, and Matthew Borzage⁷

¹Division of Cardiology, University of Southern California, Los Angeles, CA, United States, ²Biomedical Engineering, University of Southern California, Los Angeles, CA, United States, ³Cedars-Sinai Medical Center, Los Angeles, CA, United States, ⁴Radiology, Children's Hospital of Los Angeles, Los Angeles, CA, United States, ⁵Hematology Oncology, Children's Hospital Los Angeles, Los Angeles, CA, United States, ⁶Pediatrics and Radiology, Children's Hospital Los Angeles, Los Angeles, CA, United States, ⁷Neonatology, Children's Hospital Los Angeles, Los Angeles, CA, United States

Stroke is a critical complication of Sickle Cell Disease (SCD) and is predicted by increased transcranial Doppler velocities. Recent computational fluid dynamic studies demonstrate a combination of high flow and vessel tortuosity are responsible for high TCD velocities. We determined the predictors of vessel tortuosity in control subjects and SCD patients without known vasculopathy. We applied three different tortuosity metrics (distance measure, inflection count, and sum of angles method) to middle cerebral artery segments measured in 19 SCD patients and 13 controls. Both distance and inflection count metrics were increased in SCD patients but the distance metric was more discriminatory. Age and hemoglobin levels were the strongest predictors of tortuosity in SCD patients. Both terms were retained in multivariate analysis, suggesting that chronic anemia exacerbates the normal increase in vessel tortuosity with age.

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