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

Abstract

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.

Wall Tissue Remodeling Regulates Longitudinal Tension in Arteries

“…2 These factors may produce the tortuosity that is common in aged arteries. 33 Our findings generally support this interpretation, except that tortuosity occurred after axial tension was only partially offloaded. Apparently, arterial morphology becomes unstable at finite levels of axial strain.…”

The Moving Carotid Artery: A Retrospective Review of the Retropharyngeal Carotid Artery and the Incidence of Positional Changes on Serial Studies

“…12 Among our patient population, there was a trend toward association of higher grades of atherosclerosis with retropharyngeal carotid arteries compared with marginal or lateral carotid arteries. This finding was expected because patients with atherosclerotic disease frequently demonstrate tortuosity of the carotid arteries, 9 and this tortuosity would logically predispose to deviation of the artery from its usual anatomic position. However, statistical analysis of our data failed to confirm that a true correlation was present.…”

“…6 In addition to increasing age, atherosclerosis and hypertension have also been linked with abnormalities of the carotid arteries, including tortuosity, kinking, and coiling. 9 Prior studies have documented the incidence of retropharyngeal carotid arteries. 10 A recent study evaluated the position of the internal carotid arteries on cervical spine MR imaging.…”

Overexpression of Alzheimer's Disease Amyloid-β Opposes the Age-dependent Elevations of Brain Copper and Iron

“…Studies in mice and humans show that iron and copper levels increase with normal aging in several tissues, including brain (12)(13)(14)(15)(16)(17), while zinc levels either remain unchanged or show a slight decrease (14,16,18,19). Therefore, a breakdown of metal regulation could be an inevitable consequence of aging.…”