Why the study?
Does carotid tortuosity/kinking cause a significant blood pressure drop in the internal carotid artery?
Does carotid tortuosity/kinking cause a significant blood pressure drop in the internal carotid artery?
Carotid kinking causes a measurable pressure drop that increases with the kinking angle, providing a hemodynamic mechanism for potential cerebral ischemia.
Suggests possible ischemic mechanism in carotid kinking; hypothesis-generating and requires larger studies before practice change.
Background. Whether carotid tortuosity/kinking of the internal carotid artery leads to cerebral ischemia remains unclear. There is very little research about the hemodynamic variation induced by carotid tortuosity/kinking in the literature. The objective of this study was to research the blood pressure changes induced by carotid tortuosity/kinking. Methods. We first created a geometric model of carotid tortuosity/kinking. Based on hemodynamic boundary conditions, the hemodynamics of carotid tortuosity and kinking were studied via a finite element simulation. Then, an in vitro system was built to validate the numerical simulation results. The mean arterial pressure changes before and after carotid kinking were measured using pressure sensors in 12 patients with carotid kinking. Results. Numerical simulation revealed that the pressure drops increased with increases in the kinking angles. Clinical tests and in vitro experiments confirmed the numerical simulation results. Conclusions. Carotid kinking leads to blood pressure reduction. In certain conditions, kinking may affect the cerebral blood supply and be associated with cerebral ischemia.
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Wang et al. (2016) studied this question.
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