Schenk P, Temmel A, Trattnig S, Kainberger F
Universitäts-HNO-Klinik Wien.
HNO. 1996 Apr;44(4):178-85.
Elongation, coiling and/or kinking of the interal carotid artery occur in 10-25% of the population. While coiling of the internal carotid artery is ascribed to embryological causes, elongation and kinking are due to atherosclerosis or fibromuscular dysplasia. Seventy-seven patients with carotid kinking were examined using different diagnostic imaging methods. Of these, 64 underwent surgery because of cerebrovascular symptoms that ranged from local disturbances, vertigo, diplopia and cerebrovascular insufficiency producing ischemic attacks or infarction. The treatment of choice was surgical correction of the carotid kinking in symptomatic cases and, if indicated, endarterectomy of atherosclerotic lesions of the internal carotid artery to prevent ischemic stroke. Because of the anatomical position of the interal carotid artery kink there is a potential risk of complications in head and neck surgery. For this reason, the presence of carotid kinking should be excluded preoperatively by means of non-invasive diagnostic imaging, such as afforded by ultrasonic testing. The merits of the different diagnostic imaging methods to diagnose internal carotid artery disease were compared and discussed.
颈内动脉延长、盘绕和/或扭结在10%至25%的人群中出现。虽然颈内动脉盘绕归因于胚胎学原因，但延长和扭结是由动脉粥样硬化或纤维肌发育异常引起的。使用不同的诊断成像方法对77例颈内动脉扭结患者进行了检查。其中，64例因脑血管症状接受了手术，这些症状包括局部紊乱、眩晕、复视以及导致缺血性发作或梗死的脑血管供血不足。对于有症状的病例，治疗的首选方法是对颈内动脉扭结进行手术矫正，如有必要，对颈内动脉的动脉粥样硬化病变进行动脉内膜切除术以预防缺血性中风。由于颈内动脉扭结的解剖位置，在头颈外科手术中存在并发症的潜在风险。因此，术前应通过非侵入性诊断成像（如超声检查）排除颈内动脉扭结的存在。对诊断颈内动脉疾病的不同诊断成像方法的优点进行了比较和讨论。
