Characteristics of patients with extracranial cervical artery dissections involving more than a single vessels: A subgroup analysis of STOP-CAD.

Introduction
Cervical arterial dissections (CeAD) can involve either single (sCeAD) or multiple (mCeAD) arteries. Whether the involvement of a single versus multiple arteries is associated with outcomes remains unclear. We aimed to study associations between the number of affected arteries and clinical, imaging and outcome parameters.Patients And Methods
Patients with CeAD from the STOP-CAD multicenter registry study were included. Clinical, imaging, treatment and outcome parameters were compared between patients with sCeAD and mCeAD. Regression analyses were performed to identify associations with multi-arteries involvement.Results
Overall, 3858 STOP-CAD patients were included in this analysis and 443 (11.5%) had mCeAD. The presence of mCeAD was associated with age (adjusted odds ratio [aOR] 95% confidence intervals [95% CI] 0.99; (0.98-1.00)), female sex (aOR 1.5; 95% CI 1.17-1.91), recent upper respiratory infection (aOR 2.25; 95% CI 1.55-3.27), presence of connective tissue disease (aOR 3.11; 95% CI 2.32-4.17), severe arterial stenosis (aOR 1.95; 95% CI 1.95-2.58), intracranial extension (aOR 1.47; 95% CI 1.04-2.09), vertebral artery involvement (aOR 2.50; 95% CI 1.94-3.22) and presence of dissecting aneurysm (aOR 2.59; 95% CI 1.95-3.42). In adjusted analyses, mCeAD was not associated with clinical outcomes (ischemic stroke, mortality, and sICH; all p > 0.05).Conclusions
mCeAD does not appear to increase risk of subsequent stroke as compared to sCAD despite baseline risk factors suggestive of vasculopathy. mCeAD patients who did develop a stroke presented with milder strokes and less often had vessel occlusions compared to those with sCeAD. The presence of mCeAD did not impact outcomes.