INTERNAL CAROTID-ARTERY REDUNDANCY IS SIGNIFICANTLY ASSOCIATED WITH DISSECTION

Background and Purpose Redundant internal carotid arteries have been c onsidered a risk factor in tonsillectomy, adenoidectomy, and surgical treatment of peritonsillar abscess and also a potentially treatable ca use of stroke. However, an association between internal carotid artery redundancy and spontaneous dissection has not yet been clearly demons trated. Methods We reviewed, for spontaneous carotid artery dissection , records of all patients admitted to our institution during the perio d from 1986 through 1992 with the diagnosis of stroke or transient isc hemic attack. We also reviewed 108 percutaneous cerebral arteriograms performed between September 1992 and December 1992 for presence of car otid artery redundancies. Results Thirteen patients exhibited spontane ous dissection. Of these, 8 of 13 (62%) patients and 13 of 20 (65%) in ternal carotid arteries, viewed to the siphon, had significant redunda ncies, kinks, coils, or loops. Of 108 consecutive arteriograms of pati ents without dissection, in which 187 internal carotid arteries were v iewed to the siphon, there were 20 (19%) patients and 22 (12%) of 187 vessels with significant redundancy. Five patients in the dissection g roup and 2 in the nondissection group had bilateral internal carotid a rtery redundancy (P=.0019 and P=.0001, respectively). Conclusions We f ound a significant correlation between internal carotid artery redunda ncy and dissection, particularly if redundancy is present bilaterally.