Kinking of the human internal carotid artery: a statistical study in 100 healthy subjects by echocolor Doppler

Kinking of the internal carotid artery is a rather frequent anomaly. It is still controversial whether it has a clinical relevance, causing cerebral vascular disturbances, or if it is a mere morphologic anomaly. A study concerning its frequency in asymptomatic subjects and an evaluation of its possible correlations were, therefore, considered interesting.

The internal carotid artery was studied in 100 apparently healthy subjects (50 men and 50 women; age range: 18 to 98 years) with no history of atherosclerotic disease of the supra-aortic trunks, or diabetes mellitus, or hypertension. Each patient underwent color Doppler ultrasonography.

In 38 subjects out of 100, and in 53 out of 200 examined arteries (100 right and 100 left arteries), a kinking was found (26.5%). In 23 kinkings (43% of all the kinkings), the maximal systolic velocity (MSV) was greater than 1 m/sec at the level of the kinking. The kinkings were more frequent in women; such prevalence was statistically significant. The frequency of kinkings was uncorrelated with the side of the artery, the age, the body weight, the height and the length of the neck. Moreover, the presence of the kinkings was not significantly correlated with the lumen of the internal carotid artery.

Hypotheses regarding the genesis of the kinkings were discussed, and the embryogenic hypothesis was emphasized. The importance of the MSV in the diagnosis of kinkings was stressed.