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Kinking and coiling of the internal carotid artery: Clinical-statistical observations and surgical perspectives
Insights
Kinking and coiling of the internal carotid artery are more common in patients with cerebrovascular insufficiency. These arterial abnormalities may contribute to cerebral ischemic attacks, especially in younger individuals.
Area of Science:
- Neurology
- Vascular Surgery
Background:
- Kinking and coiling of the internal carotid artery (ICA) are anatomical variations that may be associated with cerebrovascular diseases.
- The clinical significance of these findings, particularly in relation to cerebral ischemic events, requires further investigation.
Purpose of the Study:
- To determine the incidence of ICA kinking and coiling in an unselected population.
- To investigate the association between ICA kinking/coiling and cerebrovascular insufficiency.
- To evaluate the efficacy of surgical interventions for symptomatic ICA kinking/coiling.
Main Methods:
- Retrospective analysis of 1,010 angiographies.
- Statistical comparison of ICA kinking/coiling incidence between patients with and without cerebrovascular insufficiency.
- Review of surgical outcomes in 19 patients who underwent corrective procedures.
Main Results:
- ICA kinking and coiling were found significantly more often in patients with cerebrovascular insufficiency compared to non-vascular patients.
- This association was particularly pronounced in age groups up to 50 years.
- Surgical correction in 19 selected patients yielded significant benefits, especially for those with recurrent ischemic episodes.
Conclusions:
- Kinking and coiling of the ICA are associated with cerebrovascular insufficiency and may contribute to cerebral ischemic attacks.
- Surgical intervention can be beneficial for carefully selected patients with symptomatic ICA kinking/coiling.
- Further research is warranted to elucidate the precise mechanisms and optimize treatment strategies.
Abstract:
The incidence of kinking and coiling of the internal carotid artery in an unselected series of 1,010 angiographies is reported. The angiographies of patients with cerebrovascular insufficiency and those of patients with other brain diseases were separately reviewed. On the basis of a statistical comparison, the finding of kinks and coils appears significantly higher in "vascular" than in "non-vascular" patients. The greater difference concerns age subgroups up to 50 years. These data give support to the assumption that both kinking and coiling of the internal carotid artery may play a role in determining cerebral ischemic attacks. Surgical experience concerns a series of 19 patients operated by various corrective procedures, including resection of the internal carotid artery and end-to-end anastomosis. It is felt that surgery, performed in appropriately selected cases, can afford significant benefits to cerebrovascular patients, especially those presenting recurrent ischemic episodes.