CURRENT DIAGNOSIS AND TREATMENT OF CAROTI D KINKING

Elongation, coiling and/or kinking of the interal carotid artery occur in 10-25% of the population. While coiling of the internal carotid ar tery is ascribed to embryological causes, elongation and kinking are d ue to atherosclerosis or fibromuscular dysplasia. Seventy-seven patien ts with carotid kinking were examined using different diagnostic imagi ng methods. Of these, 64 underwent surgery because of cerebrovascular symptoms that ranged from local disturbances, vertigo, diplopia and ce rebrovascular 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 atheroscler otic lesions of the internal carotid artery to prevent ischemic stroke . Because of the anatomical position of the interal carotid artery kin k there is a potential risk of complications in head and neck surgery. For this reason, the presence of carotid kinking should be excluded p reoperatively by means of non-invasive diagnostic imaging, such as aff orded by ultrasonic testing. The merits of the different diagnostic im aging methods to diagnose internal carotid artery disease were compare d and discussed.