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. 2021 Jun;31(2):425-430.
doi: 10.1007/s00062-020-00892-4. Epub 2020 Mar 18.

Coiling of the Internal Carotid Artery is Associated with Hypertension in Patients Suspected of Stroke

Josephus L M van Rooij  1 , Richard A P Takx  2 , Birgitta K Velthuis  1 , Jan Willem Dankbaar  1 , Pim A de Jong  1 ; DUST investigators
Affiliations

Coiling of the Internal Carotid Artery is Associated with Hypertension in Patients Suspected of Stroke

Josephus L M van Rooij et al. Clin Neuroradiol. 2021 Jun.

Abstract

Purpose: The etiology of coiling (i.e. severe elongation) of the extracranial part of the internal carotid artery (ICA) is poorly understood with the proposed etiology being congenital, atherosclerotic or hypertension. The objective was to investigate the association of coiling with hypertension, carotid artery atherosclerosis and other cardiovascular risk factors.

Methods: A case control study was performed in patients suspected of stroke, with (cases) or without (controls) coiling of the ICA determined on compute tomography angiography (CTA). Baseline characteristics included age, gender, hypertension, diabetes, smoking and hypercholesterolemia. Coiling of the ICA and atherosclerotic plaque at the carotid bifurcation were assessed on CTA. Logistic regression analyses were conducted.

Results: Coiling was identified in 108 patients with a median age of 71 years. Cases were compared with 256 controls with a median age of 69 years. Hypertension was present in 63% of the patients with coiling compared to 51% in the control group. Univariable analysis showed that hypertension was significantly associated with coiling, with an odds ratio of 1.65 (95% confidence interval (CI) 1.04-2.61, p = 0.034). Multivariable analysis corrected for age and sex resulted in an odds ratio of 1.71 (95% CI 1.05-2.80, p = 0.032), while correcting for atherosclerotic plaque at the bifurcation yielded an odds ratio of 1.63 (95% CI 1.00-2.66, p = 0.049). Age and atherosclerotic plaque were not significantly associated with coiling.

Conclusion: The main finding of this study was the significant association of hypertension with coiling of the ICA and the absence of an association with age, plaques and atherosclerotic risk factors other than hypertension.

Keywords: Coiling; Dolichoarteriopathy; Hypertension; Internal carotid artery; Tortuosity.

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Conflict of interest statement

J.L.M. van Rooij, R.A.P. Takx, B.K. Velthuis, J.W. Dankbaar, P.A. de Jong and the DUST investigators declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
3D reconstructed CT image demonstrating coiling of both internal carotid arteries in a circular configuration
Fig. 2
Fig. 2
Study population selection flow chart
See this image and copyright information in PMC

References

    1. Yu J, Qu L, Xu B, Wang S, Li C, Xu X, et al. Current understanding of dolichoarteriopathies of the internal carotid artery: a review. Int J Med Sci. 2017;14:772–784. doi: 10.7150/ijms.19229. - DOI - PMC - PubMed
    1. Cioffi FA, Meduri M, Tomasello F, Bonavita V, Conforti P. Kinking and coiling of the internal carotid artery: clinical-statistical observations and surgical perspectives. J Neurosurg Sci. 1975;19(1–2):15–22. - PubMed
    1. Beigelman R, Izaguirre AM, Robles M, Grana DR, Ambrosio G, Milei J. Are kinking and coiling of carotid artery congenital or acquired? Angiology. 2010;61:107–112. doi: 10.1177/0003319709336417. - DOI - PubMed
    1. Sarkari NB, Holmes JM, Bickerstaff ER. Neurological manifestations associated with internal carotid loops and kinks in children. J Neurol Neurosurg Psychiatry. 1970;33:194–200. doi: 10.1136/jnnp.33.2.194. - DOI - PMC - PubMed
    1. Togay-Isikay C, Kim J, Betterman K, Andrews C, Meads D, Tesh P, et al. Carotid artery tortuosity, kinking, coiling: stroke risk factor, marker, or curiosity? Acta Neurol Belg. 2005;105:68–72. - PubMed