Measurement of elongation of the internal carotid artery with its pathological tortuosity

The prevalence of pathological tortuosity of the internal carotid arteries (ICA) in the general population is 10–40 %. Currently, the effectiveness of surgical treatment of patients with pathological tortuosity of the ICA has been proven. When choosing a method of surgical treatment, the severity of deformation and the degree of elongation of the internal carotid artery is important. Of the methods proposed in practice for surgical treatment of pathological deformities of the ICA with pronounced deformities, the most optimal is the method of ICA redressation with transposition into the common carotid artery and replantation into a new orifice. The tortuosity index used and described in the literature characterizes the severity of tortuosity, but has no practical surgical significance. A parameter is proposed for determining the degree of elongation of the extracranial part of the ICA, taking into account its practical significance in vascular surgery, the excess length of the ICA is determined to determine the degree of ICA redressation and the level of transposition into the common carotid artery at the preoperative stage. The term of the tortuosity Delta is proposed, defined by the formula: the actual length of the extracranial part of the ICA minus the direct length of the ICA. The presented clinical observation describes the method of measuring of tortuosity Delta and its practical significance in preoperative analysis in determining the optimal surgical method.