NONINVASIVE DIAGNOSTICS OF EXTRACRANIAL ARTERIES TORTUOSITY
DOI:
https://doi.org/10.61699/cjmps-v1-i4-p60-72Keywords:
Carotid pathology, magistral arteries, spiral elongation, spiral deformationAbstract
Deformations of carotid artery – deviation, tortuosity, coiling, hold the 2nd placeamong other carotid pathologies. They are the cause of 10-17% of cerebrovasculardisorders. It should also be noted that this pathology is common for a relatively youngage. It is considered that in the elderly carotid deformation is an acquired lesion mostcommonly seen in patients suffering from arteriosclerosis and hypertension, while inchildren and younger patients, the kinks and coils are congenital. For diagnostics ofdeformations of magistral arteries, highly efficient non-invasive methods are applied:ultrasound duplex-scanning, MR angiography, and multi-slice CT angiography. We havestudied deformations of magistral carotid and vertebral arteries in cases of isolatedatherosclerosis, isolated arterial hypertension, and a combination of atherosclerosisand hypertension. Out of 205 patients we diagnosed deformations of carotid arteriesin 93 (30%) cases, and deformations of vertebral arteries in 64 (21%) cases. Bilateraldeformation of carotid arteries was diagnosed in 43 (17%) cases. C- or S-shaped deformationsin 55 (81%) cases were located in proximal or medial parts of CCA or ICA. 76%of patients with this pathology had arterial hypertension. In the case of C- or S-typedeformation rate amounted to 30%, in the case of coiling increase of flow it reached50%, and in the case of kinking – exceeded 60%. In the case of C- or S-type elongation,flow volume (Q) is practically within the normal range - 488±38 ml/min. In the case ofspiral shape elongation, it showed the tendency of decrease -402±22 ml/min, which ismore obvious in the case of kinking - 332±22 ml/min. The frequency of elongations ispractically the same in the case of isolated atherosclerosis or hypertension, however,in the case of their combination the frequency increases. In order to study the impactof the deformation of magistral arteries on intracranial hemodynamics, we examined84 patients without any hemodynamically significant atherosclerotic pathology of carotids.We found a total of 91 elongations: In the case of C- or S-shaped deformation,flow parameters remain within the normal range, as in the case of spiral elongation orcoiling. In the case of kinking, there is an obvious tendency for a decrease in flow rate – the average flow rate is 20% below the normal value. Our data correspond to similar data of other authors, who revealed the tendency of a 20-35% decrease of flow rate in the ipsilateral middle cerebral artery, in case of significant tortuosity or kinking of the carotid artery.
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