, Volume 57, Issue 2, pp 149–153 | Cite as

Association between internal carotid artery dissection and arterial tortuosity

  • Luca Saba
  • Giovanni Maria Argiolas
  • Suna Sumer
  • Paolo Siotto
  • Eytan Raz
  • Roberto Sanfilippo
  • Roberto Montisci
  • Mario Piga
  • Max Wintermark
Diagnostic Neuroradiology



Carotid artery dissection is an important cause of ischemic stroke in all age groups, particularly in young patients. The purpose of this work was to assess whether there is an association between the presence of an internal carotid artery dissection (ICAD) and the arterial tortuosity.


This study considered 124 patients (72 males and 52 females; median age 57 years) with CT/MR diagnosis of ICAD of the internal carotid artery were considered in this multi-centric retrospective study. The arterial tortuosity was evaluated and, when present, was categorized as elongation, kinking, or coiling. For each patient, both the right and left sides were considered for a total number of 248 arteries in order to have the same number of cases and controls. Fisher’s exact test was applied to test the association between elongation, kinking, coiling, dissection, and the side affected by CAD.


Fisher’s exact test showed a statistically significant association between the ICAD and kinking (p = 0.0089) and coiling (p = 0.0251) whereas no statistically significant difference was found with arterial vessel elongation (p = 0.444). ICAD was more often seen on the left side compared to the right (p = 0.0001). These results were confirmed using both carotid arteries of the same patient as dependent parameter with p = 0.0012, 0.0129, and 0.3323 for kinking, coiling, and elongation, respectively.


The presence of kinking and coiling is associated with ICAD.


Carotid Dissection 


Ethical standards and patient consent

We declare that all human and animal studies have been approved by the Institutional Review Board of the Azienda Ospedaliero Universitaria Department of Radiology and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Patient consent was waived due to the retrospective nature of this study.

Conflict of interest

We declare that we have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Luca Saba
    • 1
  • Giovanni Maria Argiolas
    • 2
  • Suna Sumer
    • 3
  • Paolo Siotto
    • 2
  • Eytan Raz
    • 4
    • 6
  • Roberto Sanfilippo
    • 5
  • Roberto Montisci
    • 5
  • Mario Piga
    • 1
  • Max Wintermark
    • 3
  1. 1.Department of RadiologyAzienda Ospedaliero Universitaria (A.O.U.)MonserratoItaly
  2. 2.Department of RadiologyAzienda Ospedaliero Brotzu (A.O.B.)di CagliariItaly
  3. 3.Neuroradiology, UVA Department of RadiologyNeuroradiology DivisionCharlottesvilleUSA
  4. 4.Department of RadiologyNew York University School of MedicineNew YorkUSA
  5. 5.Department of Vascular SurgeryAzienda Ospedaliero Universitaria (A.O.U.)di CagliariItaly
  6. 6.Department of Neurology and PsychiatrySapienza University of RomeRomeItaly

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