Surgical treatment of kinked internal carotid arteries

Vollmar, J; Nadjafi, A; Stalker, C.G.

doi:10.1002/bjs.1800631103

Cited by 50 publications

(21 citation statements)

References 7 publications

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“…The challenge resides in the fact that definitions are variable and overlap [4,[10][11][12][13][14] . Therefore, the interpretation of frequencies and its implications are challenging.…”

Section: Discussionmentioning

confidence: 99%

Internal Carotid Artery S-Shaped Curve as a Marker of Fibromuscular Dysplasia in Dissection-Related Acute Ischemic Stroke

Haussen¹,

Jadhav²,

Rebello³

et al. 2016

Intervent Neurol

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Background and Purpose: Craniocervical fibromuscular dysplasia (FMD) is associated with dissections and with S-shaped curves in the internal carotid artery (ICA). We evaluated the occurrence of S-curves in patients presenting with acute strokes due to ICA steno-occlusive dissections. Methods: This was a retrospective review of the interventional databases of two academic tertiary-care institutions. The presence of ICA S-shaped curves, C-shaped curves, 360-degree loops, as well as classic FMD and atherosclerotic changes at the ICA bulb and curve/loop was determined. Cases of carotid dissections were compared with a control group (consecutive non-tandem anterior circulation strokes). Results: Twenty-four patients with carotid dissections were compared to 92 controls. Baseline characteristics and procedural variables were similar, with the exception of younger age, less frequent history of hypertension, diabetes, atrial fibrillation and stent retriever use in patients with dissections. The rates of mTICI2b-3 reperfusion, parenchymal hematoma, good outcome and mortality were similar amongst groups. The frequency of S-curves (any side without superimposed atherosclerosis) was 29% in the dissection group versus 7% in controls (p < 0.01). S-curves were typically mirror images within the dissection group (85% had bilateral occurrence). The frequency of C-shaped and 360-degree curves was similar between groups. FMD changes within the craniocervical arteries were statistically more common in dissection patients. Ten patients (41%) of the dissection group had S-curves or classic FMD changes. Multivariate analysis indicated that S-curves were independently associated with the presence of dissections. Conclusion: S-shaped ICA curves are predictably bilateral, highly associated with carotid dissections in patients with moderate to severe strokes, and may suggest an underlying presence of FMD.

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“…The challenge resides in the fact that definitions are variable and overlap [4,[10][11][12][13][14] . Therefore, the interpretation of frequencies and its implications are challenging.…”

Section: Discussionmentioning

confidence: 99%

Internal Carotid Artery S-Shaped Curve as a Marker of Fibromuscular Dysplasia in Dissection-Related Acute Ischemic Stroke

Haussen¹,

Jadhav²,

Rebello³

et al. 2016

Intervent Neurol

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“…These abnormalities are reported as asymptomatic in up to 80% of the cases ;12,23 otherwise, they are reported in 4-20% of cases in patients with neurologic or ocular ischemic symptoms, probably secondary to a thromboembolic or hemodynamic mechanism.lo-12, 23 The thromboembolic mechanism is secondary to endothelial lesions determined by local flow alterations,12 but the more important mechanism seems to be hemodynamic. When the angle of the abnormality reaches a high degree ( < 60°), both in permanent and transient conditions, for example, head rotation, especially in atherosclerotic patients, the hemodynamic mechanism becomes effective.…”

Section: Introductionmentioning

confidence: 99%

Tortuosity, Kinking, and Coiling of the Carotid Artery: Expression of Atherosclerosis or Aging?

et al. 1998

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The etiology of carotid abnormalities is both congenital than acquired. The aim of this study was to clarify the role of aging and atherosclerosis in the acquired cases, and the role of these abnormalities in hemodynamic alterations and neurologic symptoms. Over a 1-year period the authors studied all the subjects undergoing carotid examination by continuous-wave and color-coded Doppler sonography at an Angiology Unit. They evaluated neurologic symptoms; risk factors for atherosclerosis; number, sites, and kinds of carotid abnormalities; atherosclerotic lesions; stenosis; hemodynamic alterations of the carotid; and other localizations of atherosclerotic diseases. There were 469 subjects: 272 (58%) with abnormalities (group 1) and 197 (42%) without abnormalities (group 2). The total number of abnormalities was 479 (104 tortuosities, 262 kinkings, and 113 coilings). The abnormalities were more prevalent in the elderly (P<0.001) and in women (P<0.001). In group 1 they found significant prevalences of hyperlipemia (P<0.001), hypertension (P<0.01), chronic cigarette smoking (P<0.01), and ischemic heart disease (P<0.05). Carotid atherosclerotic lesions were more prevalent in group 1 than in group 2 (P<0.001); among the patients with atherosclerotic carotid lesions, those in group 1 were older than those in group 2 (P<0.001). Tortuosity seemed to be associated with fewer hemodynamic alterations. The authors conclude that atherosclerosis, hypertension, and aging may play an important role in producing carotid abnormalities. The aging seemed more important than atherosclerosis. Only a prospective study of patients with carotid abnormalities and no atherosclerotic lesion will clarify the role of hemodynamics and neurologic symptomatology.

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“…Similar investigations were performed by other authors. 2–7 The major reviews of this subject were made by Leipzig and Dohrmann 8 in 1986, Carcoforo et al 9 in 1997, and Pellegrino et al 10 in 1998. Leipzig and Dohrmann 8 reported 800 cases of anomalies of the internal carotid artery, divided into kinking or coiling anomalies.…”

Section: Discussionmentioning

confidence: 99%

Internal Carotid Artery Transposition as Risk Factor in Pharyngeal Surgery

Galletti¹,

Bucolo²,

Abbate³

et al. 2002

The Laryngoscope

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Some of the anomalies of the internal carotid artery can determine a bulge of the posterior pharyngeal wall. Because of the submucous position of the carotid artery at this level, such anomalies can constitute a risk factor for serious hemorrhage in routine surgical procedures that have become outpatient procedures and are often performed by inexperienced surgeons. The three-dimensional time-of-flight magnetic resonance angiogram together with Doppler ultrasonography were shown to be the most accurate imaging techniques to evaluate these anomalies.

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Surgical treatment of kinked internal carotid arteries

Cited by 50 publications

References 7 publications

Internal Carotid Artery S-Shaped Curve as a Marker of Fibromuscular Dysplasia in Dissection-Related Acute Ischemic Stroke

Internal Carotid Artery S-Shaped Curve as a Marker of Fibromuscular Dysplasia in Dissection-Related Acute Ischemic Stroke

Tortuosity, Kinking, and Coiling of the Carotid Artery: Expression of Atherosclerosis or Aging?

Internal Carotid Artery Transposition as Risk Factor in Pharyngeal Surgery

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