Comprehensive assessment of internal carotid artery tortuosity combined with stenosis regarding the indications for surgical treatment

Objective. To evaluate diagnostic significance of tortuosity index (TI) and blood flow velocity gradient (BVG) in comprehensive assessment of patients with internal carotid artery (ICA) tortuosity with minor atherosclerotic stenosis and critical stenosis of ICA regarding the indications for surgical treatment. Material and methods. A retrospective single-center study included 135 patients with unilateral ICA tortuosity divided into 2 groups: 55 patients with ICA tortuosity and stenosis70%. Mean age was 63.5±10.3 years. All patients underwent CT angiography of extracranial arteries and Doppler ultrasound. TI, BVG and deformation type (C-type, S-type, coiling, and kinking) were assessed. TI ≥1.2 and/or BVG >2.5 determined hemodynamically significant tortuosity. These parameters were compared between groups using descriptive statistics, correlation and ROC analysis. Results. Both groups were comparable in age and gender. Smoking (OR=4.6; p