Differences between patients with unilateral and bilateral internal carotid kinking in age distribution, risk factors...

Clinical differences between patients with and without internal carotid kinking (ICK) were frequently discussed in previous literatures. However, studies comparing patients with unilateral and bilateral ICK for their characteristics are scarce. The purpose of this study was to identify the differences between these patients in age distribution, risk factors and clinical relevance.

From November 1, 2013 to January 30, 2014, all the patients who underwent carotid CT angiography and skull MRI for various medical reasons in our hospital were consecutively enrolled. Patient data were assessed simultaneously according to medical records. Then, age distribution, risk factors and prevalence of subcortical ischemic change in patients with unilateral ICK (unilateral group) and those with bilateral ICK (bilateral group) were compared statistically.

A total of 13.5% and 14.9% study patients had unilateral and bilateral ICK, respectively. Age distribution of ICK prevalence was similar between the two groups. Compared to the unilateral group, being female was the only independent risk factor related to bilateral ICK, in both univariate (χ2=11.76, P=0.001) and logistic regression (OR =1.34, 95% CI: 1.1.18-1.65, P=0.001) analyses. Moreover, the prevalence rates of leukoaraiosis (72.1 vs. 54.8%, P=0.004) and multiple lacunar infarct (62.3 vs. 42.9%, P=0.009) in the bilateral group were significantly higher compared with the values obtained for the unilateral group.

Compared to patients with unilateral ICK, female gender is the only risk factor associated with bilateral ICK, and subcortical ischemic change is significantly more prevalent in patients with bilateral ICK.