Increased Internal Carotid Artery Tortuosity: Risk Factor fo
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Spontaneous cervicocerebral artery dissection (sCCD) is an important cause of ischaemic stroke that often occurs in young and middle aged patients. The study, published by the European Journal of Vascular and Endovascular surgery was conducted to investigate the correlation between the tortuosity of the carotid artery and sCCD.

Patients with confirmed sCCD who underwent computed tomography angiography (CTA) were reviewed retrospectively. Age and sex matched patients having CTA were used as controls. The tortuosity indices of the cervical arteries were measured from the CTA images. The carotid siphon and the extracranial internal carotid artery (ICA) were evaluated according to morphological classification. The carotid siphons were classified into five types. The extracranial ICA was categorized as simple tortuosity, coiling or kinking. Independent risk factors for sCCD were investigated using multivariable analysis.

The study included sixty-six patients with sCCD and 66 controls. There were no differences in vascular risk factors between the two groups. The internal carotid tortuosity index (ICTI) and vertebral tortuosity index (VTI) were higher in the patients with sCCD than in the controls. Type III and Type IV carotid siphons were more common in patients with sCCD. The prevalence of any vessel tortuosity, coiling, and kinking of the extracranial ICA was higher in the patients with sCCD. ICTI, and Type III carotid siphons were independently associated with the risk of sCCD.

Conclusively, Arterial tortuosity is associated with sCCD, and greater tortuosity of the cervical artery may indicate an increased risk of arterial dissection.