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Dolichocarotids: echo-color Doppler evaluation and clinical role
Marco Matteo Ciccone1, Rakesh K Sharma, Pietro Scicchitano
1Cardiology Unit, Emergency and Organ Transplantation Department(DETO), University of Bari.
Dolichocarotids (DCs) are rare carotid findings. Echo-color Doppler (ECD) accurately detects DCs, with kinking associated with cardiovascular death, highlighting ECD
Area of Science:
- Vascular Imaging
- Cerebrovascular Diseases
- Diagnostic Accuracy
Background:
- Dolichocarotids (DCs) are uncommon carotid artery elongations, found in 2-6% of the population.
- DCs may be asymptomatic or linked to cerebrovascular events.
- Carotid echo-color Doppler (ECD) and selective angiography are standard detection methods.
Purpose of the Study:
- To assess the sensitivity, specificity, and accuracy of ECD in detecting DCs.
- To monitor DC curvature changes over five years.
- To evaluate the association of DCs with TIA, ischemic stroke, myocardial infarction, and cardiovascular death.
Main Methods:
- 112 patients with DCs underwent carotid ECD and angiography.
- Patients had persistent neurological symptoms unexplained by initial ultrasound.
- Follow-up extended to five years.
Main Results:
- ECD demonstrated 100% sensitivity for tortuosity/coiling and 96% for kinking.
- Overall ECD accuracy ranged from 92% to 100%.
- Significant increases in tortuosity and kinking angles were observed over five years; kinking correlated with cardiovascular death.
Conclusions:
- DCs increase the risk of disabling and fatal cerebrovascular events.
- ECD is a reliable and reproducible method for DC detection.
- ECD plays a crucial role in managing patients with dolichocarotids.
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