Tortuous Carotid Arteries and Their Clinical Implications: A Report of Two Cases

The tortuous carotid artery is a rare anatomic abnormality defined as vascular elongation leading to an altered course. It can be discovered incidentally or have clinically significant manifestations. The most common location is the internal carotid artery or, less commonly, the common carotid artery. Bilateral tortuous carotid arteries can also occur, leading to "kissing carotids" where the carotid arteries are juxtaposed. We describe two cases of carotid artery tortuosity in patients with risk factors associated with its development. One case is of a 91-year-old female presenting with a cerebrovascular accident and an incidental finding of tortuosity of the right common carotid artery mimicking the appearance of "kissing carotids." The other case concerns a 66-year-old female with a symptomatic tortuous left internal carotid artery. This report aims to inform clinicians of the differences in the anatomical features, pathogenesis, and possible clinical implications of these variants.