Correlation between kinking and coiling of the carotid arteries as assessed using MDCTA with symptoms and degree of stenosis

Abstract

To evaluate whether the presence of kinking and coiling of the carotid arteries is associated with symptoms and an increased degree of carotid artery stenosis. One hundred and fifty-three consecutive patients examined using multidetector-row computed tomography angiography (MDCTA) were studied retrospectively. The arterial phase was obtained by injecting 4-6ml/s of contrast material. A total of 306 carotid arteries were assessed for the presence of tortuosity. The degree of carotid artery stenosis was measured according to North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. Logistic regression analysis was performed to determine whether an independent association existed between the presence of vessel tortuosity, symptoms, and the degree of carotid artery stenosis. Kinking was detected on 37 occasions (12.1%) and coiling on 20 occasions (6.5%). Using Yates's corrected chi-square test, an association between kinking and symptoms (p=0.002) was observed, but not between coiling and symptoms (p=0.31). Logistic regression confirmed that the strongest association was present between stenosis degree and symptoms (p=0.001), but kinking (p=0.009) and age (p=0.001) were also significantly associated with symptoms. A Mann-Whitney test did not demonstrate correlation between coiling (p=0.16) or kinking (p=0.22) and increased degree of carotid artery stenosis. The results suggest that kinking may be associated with symptoms, whereas coiling does not appear to be associated with symptoms. The degree of carotid artery stenosis severity is not related to the presence of vessel tortuosity.