Endothelial dysfunction in carotid elongation

A b s t r a c t BACKGROUND AND PURPOSE Internal carotid artery (ICA) elongation (coiling and kinking) has been suggested as a risk factor for carotid dissection. Since vasomotion is known to be impaired in spontaneous cervical vessel dissection, we investigated whether endothelial-dependent vasodilation in subjects with carotid coiling and kinking is compromised. METHODS We undertook a case-control study using high-resolution ultrasound and measured flow mediated dilation (FMD) of the brachial artery in 80 subjects with carotid elongation and in 80 age- and sex-matched healthy controls (HC). The hemodynamic impact of carotid elongation was taken into consideration subdividing mild/moderate kinking from severe kinking according to a peak systolic blood flow velocity >150 cm/s. RESULTS FMD did not differ among subjects with coiling (14.51 ± 7.86%), mild/moderate kinking (14.38 ± 9.58%) and HC (15.53 ± 8.48%), while subjects with a severe kinking had a significantly lower FMD (8.38 ± 3.26). CONCLUSIONS Among subjects with carotid elongation, those with severe kinking have an impaired endothelial-dependent vasodilation and might be prone to carotid dissection.