Carotid artery tortuosity
Updates to Article Attributes
Carotid artery tortuosity is the elongation of the extracranial carotid arteries with redundancy and/or altered course, which may present on imaging as kinking, coiling, and/or looping 1,2.
Clinical presentation
Carotid artery tortuosity is mostly (~80%) asymptomatic. When symptomatic (~12.5%, range 4-20%), it occurs presents with neurological symptoms (e.g. dizziness, tinnitus, stroke) 3,4.
Pathology
The pathogenesis of carotid artery tortuosity is unknown 4.
Associations
- hypertension 3
- ageing 3
- atherosclerosis/atheroma 3
- obesity 4
- connective tissue diseases, e.g. Marfan syndrome, Loeys-Dietz syndrome, neurofibromatosis type 1 4
- congenital: failure in the development process of the third aortic arch and the dorsal aorta in the embryonic period 3
Classification
Carotid artery tortuosity can be classified into three different types 4:
- type 1: artery with a non-rectilinear section and an angle >90º
- type 2: artery with a section in the form of a curl that generates an angle of 360º about its transverse axis
- type 3: twist from the bending of ≥2 segments of an artery with an internal angle of 90º
Radiographic features
Ultrasound
- morphological features in grayscale
- haemodynamic values in spectral Doppler
CT
CT angiography allows for 3D reconstruction and a precise assessment of the degree of tortuosity of the artery.
Angiography (DSA)
Angiography allows characterising the type of tortuosity and has a high sensitivity to detect it.
Treatment
- arterial transposition is criticised for not removing arterial elongation
- vascular surgery, e.g. segmental resection and end-to-end anastomosis
- endarterectomy technique with eversion, which allows correction of severe elongation and kinking of the ICA 5
-<p><strong>Carotid artery tortuosity</strong> is the elongation of the extracranial <a href="/articles/carotid-artery">carotid arteries</a> with redundancy and/or altered course, which may present on imaging as kinking, coiling and/or looping <sup>1,2</sup>.</p><h4>Clinical presentation</h4><p>Carotid artery tortuosity is mostly (~80%) asymptomatic. When symptomatic (~12.5%, range 4-20%), it occurs presents with neurological symptoms (e.g. dizziness, <a href="/articles/tinnitus">tinnitus</a>, <a href="/articles/stroke">stroke</a>) <sup>3,4</sup>.</p><h4>Pathology</h4><p>The pathogenesis of carotid artery tortuosity is unknown <sup>4</sup>.</p><h5>Associations</h5><ul>- +<p><strong>Carotid artery tortuosity</strong> is the elongation of the extracranial <a href="/articles/carotid-artery">carotid arteries</a> with redundancy and/or altered course, which may present on imaging as kinking, coiling, and/or looping <sup>1,2</sup>.</p><h4>Clinical presentation</h4><p>Carotid artery tortuosity is mostly (~80%) asymptomatic. When symptomatic (~12.5%, range 4-20%), it presents with neurological symptoms (e.g. dizziness, <a href="/articles/tinnitus">tinnitus</a>, <a href="/articles/stroke">stroke</a>) <sup>3,4</sup>.</p><h4>Pathology</h4><p>The pathogenesis of carotid artery tortuosity is unknown <sup>4</sup>.</p><h5>Associations</h5><ul>