TORTUOSITY, KINKING, AND COILING OF THE CAROTID-ARTERY - EXPRESSION OF ATHEROSCLEROSIS OR AGING

The etiology of carotid abnormalities is both congenital than acquired . The aim of this study was to clarify the role of aging and atheroscl erosis in the acquired cases, and the role of these abnormalities in h emodynamic alterations and neurologic symptoms. Over a 1-year period t he authors studied all the subjects undergoing carotid examination by continuous-wave and color-coded Doppler sonography at an Angiology Uni t. They evaluated neurologic symptoms; risk factors for atherosclerosi s; number, sites, and kinds of carotid abnormalities; atherosclerotic lesions; stenosis; hemodynamic alterations of the carotid; and other l ocalizations of atherosclerotic diseases. There were 469 subjects: 272 (58%) with abnormalities (group 1) and 197 (42%) without abnormalitie s (group 2). The total number of abnormalities was 479 (104 tortuositi es, 262 kinkings, and 113 ceilings). The abnormalities were more preva lent in the elderly (P<0.001) and in women (P<0.001). In group 1 they found significant prevalences of hyperlipemia (P<0.001), hypertension (P<0.01), chronic cigarette smoking (P<0.01), and ischemic heart disea se (P<0.05). Carotid atherosclerotic lesions were more prevalent in gr oup 1 than in group 2 (P<0.001); among the patients with atherosclerot ic carotid lesions, those in group I were older than those in group 2 (P<0.001). Tortuosity seemed to be associated with fewer hemodynamic a lterations. The authors conclude that atherosclerosis, hypertension, a nd aging may play an important role in producing carotid abnormalities . The aging seemed more important than atherosclerosis. Only a prospec tive study of patients with carotid abnormalities and no atherosclerot ic lesion will clarify the role of hemodynamics and neurologic symptom atology.