Are the carotid kinking and coiling underestimated entities?

Radak, Djordje; Babić, Srdjan; Tanasković, Slobodan; Matić, Predrag; Sotirović, Vuk; Stevanović, Predrag; Jovanović, Predrag; Gajin, Predrag

doi:10.2298/vsp110722001r

Cited by 12 publications

(32 citation statements)

References 31 publications

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“…(11,12) Kinking occurs mostly in elderly men, and is associated with atherosclerotic pathology, while coiling is more common in younger women. (13) From a series of more than 800 cases of tortuosity and kinking of the ICA, there was a predominance in terms of sex, and some of these abnormalities were bilateral. (14) CAs are rarely observed in children or in young adults.…”

Section: Epidemiologymentioning

confidence: 99%

“…(21) Currently it is known that arterial blood vessels are prone to deformation when exposed to elevated blood pressure. (13,(23)(24)(25)(26) However, a clear link between vascular risk factors and kinking and coiling is still not fully understood.…”

Section: Epidemiologymentioning

confidence: 99%

“…(13) It has been proven that reduction in regional cerebral flow in cases of extracranial elongation of carotid segments appears with 30-35 mL per min (normal range 50-60 mL/min/100g. brain tissue).…”

Section: Clinical and Histopathologic Featuresmentioning

confidence: 99%

“…Correction of kinking and coiling is performed with peroperative mortality rate below 1% and low postoperative morbidity. (5,13) It is noteworthy that all internal carotid reconstructive procedure is subject to technical difficulties and complications associated with surgery.…”

Section: Complementary Studiesmentioning

confidence: 99%

“…(13) There are reports showing that kink of ICA is a potentially hazardous condition and surgical treatment with revascularization offers good results. (11,34) Some studies concluded that in patients with cerebrovascular insufficiency associated with stenotic kinking, ruling out any other cause of symptomatology, the kink correction improves symptoms and protects against recurrent ipsilateral cerebral ischemia.…”

Section: Complementary Studiesmentioning

confidence: 99%

See 4 more Smart Citations

Clinical implications of internal carotid artery tortuosity, kinking and coiling: a systematic review

Zenteno¹,

Zavaleta²,

Lee³

2014

Romanian Neurosurgery

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Anatomical variations of the internal carotid artery are diverse. Abnormalities in their geometry and paths are commonly identified by ultrasonography and angiography. The surgical correction of symptomatic CAs is better in preventing stroke compared with best medical therapy, as well as it completely eliminates the symptoms in patients with nonhemispheric symptoms.The ICA anomalies may be dangerous and represent a risk factor for massive bleeding. Suture ligatures can penetrate and occlude torn vessels, scalpels or biting instruments can lacerate vessels, and indirectly conducted electric cauterization can burn the soft of bony tissues.

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Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: Clinical and Histopathologic Featuresmentioning

confidence: 99%

Section: Complementary Studiesmentioning

confidence: 99%

Section: Complementary Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Clinical implications of internal carotid artery tortuosity, kinking and coiling: a systematic review

Zenteno¹,

Zavaleta²,

Lee³

2014

Romanian Neurosurgery

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Surgical and embryological perspective of a big loop of internal carotid artery extending laterally beyond internal jugular vein

Nayak

Shetty

2020

Surg Radiol Anat

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Knowledge of variations of the internal carotid artery is significant to surgeons and radiologists. The internal carotid artery normally runs a straight course in the neck. Its anomalies can lead to its iatrogenic injuries. We report a case of a large loop of the internal carotid artery in a male cadaver aged about 75 years. The common carotid artery terminated by dividing it into the external carotid artery and internal carotid arteries at the level of the upper border of the thyroid cartilage. From the level of origin, the internal carotid artery coursed upwards, backwards and laterally, and formed a large loop behind the internal jugular vein. The variation was found on the left side of the neck and was unilateral. The uncommon looping of the internal carotid artery might result in altered blood flow to the brain and may lead to misperceptions in surgical, imaging, and invasive procedures.

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Prevalence and morphological changes of carotid kinking and coiling in growth: an echo-color Doppler study of 2856 subjects between aged 0 to 96 years

Pino

Franchina

Costa

et al. 2020

Int J Cardiovasc Imaging

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Extracranial internal carotid artery (EICA) kinking and coiling are the most frequently reported carotid anomalies in the literature. Embryogenic and acquired causes for such anomalies have been postulated but the prevalence of kinking and coiling has not been well characterized across age categories. The aim of this study is to evaluate the prevalence of EICA coiling and kinking among different age groups to better understand its potential causes and changes during the course of life. A total of 2856 subjects aged 0 to 96 years were studied by echo-color Doppler (ECD). Morphology and anatomical anomalies of the EICA were assessed. Patients with anatomical anomalies were stratified by age groups and the prevalence of EICA abnormalities was calculated. The maximal velocity recorded at the level of the kinking was compared with that measured in the common carotid artery and the peak systolic velocity kinking ratio (PSVKR) was calculated. A total of 284 subjects (9.94% of the sample) were found to have kinking or coiling of the EICA. The prevalence was significantly higher at the extremes of age (≤ 20 and > 60 years old, p < 0.001) supporting the hypothesis of a reduction with growth and a new increase in the elderly. PSVKR was higher in subjects with more severity kinking. This study showed a higher prevalence of EICA coiling and kinking in the very young and in the elderly. This bimodal prevalence distribution supports the hypothesis of a congenital anomaly that resolves with somatic growth, while advanced age with its many anatomical changes leads to its reappearance or worsening. Studies with longitudinal follow-up and paired observation are required to support this hypothesis.

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Are the carotid kinking and coiling underestimated entities?

Abstract: nem

Cited by 12 publications

References 31 publications

Clinical implications of internal carotid artery tortuosity, kinking and coiling: a systematic review

Clinical implications of internal carotid artery tortuosity, kinking and coiling: a systematic review

Surgical and embryological perspective of a big loop of internal carotid artery extending laterally beyond internal jugular vein

Prevalence and morphological changes of carotid kinking and coiling in growth: an echo-color Doppler study of 2856 subjects between aged 0 to 96 years

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