[Current aspects in diagnosis and therapy of carotid artery kinking]

Abstract

Elongation, coiling and/or kinking of the interal carotid artery occur in 10-25% of the population. While coiling of the internal carotid artery is ascribed to embryological causes, elongation and kinking are due to atherosclerosis or fibromuscular dysplasia. Seventy-seven patients with carotid kinking were examined using different diagnostic imaging methods. Of these, 64 underwent surgery because of cerebrovascular symptoms that ranged from local disturbances, vertigo, diplopia and cerebrovascular insufficiency producing ischemic attacks or infarction. The treatment of choice was surgical correction of the carotid kinking in symptomatic cases and, if indicated, endarterectomy of atherosclerotic lesions of the internal carotid artery to prevent ischemic stroke. Because of the anatomical position of the interal carotid artery kink there is a potential risk of complications in head and neck surgery. For this reason, the presence of carotid kinking should be excluded preoperatively by means of non-invasive diagnostic imaging, such as afforded by ultrasonic testing. The merits of the different diagnostic imaging methods to diagnose internal carotid artery disease were compared and discussed.