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Correspondence to Author: Aymer Coşar ¹MD, Mehmet Erkan Üstün ² MD,PhD. 

1. Department of Neurosurgery, Yenimahalle Training and Research Hospital, University of Yıldırım Beyazıt, Ankara, Turkey.
2. Department of Neurosurgery and Anatomy, Private Clinic, Ankara, Turkey.

DOI: 10.52338/wnsr.2025.4933

Abstract:

Carotid artery dolicoarteriopathies, including elongation, kinking, and coiling, are linked to various cerebrovascular dysfunctions. Kinking, categorized by Metz et al., is graded by angle severity: Grade 1 (90-60°), Grade 2 (60-30°), and Grade 3 (<30°). In Grade 2 and 3, reduced blood flow heightens ischemic risk, contributing to hemodynamic instability and cerebrovascular insufficiency. While most symptomatic cases undergo endovascular or surgical correction, some patients with severe kinking remain asymptomatic, questioning current understanding. In 52 cases of carotid artery kinking, we observed stenosis in symptomatic patients, differing from the expected arterial enlargement seen in dolicoarteriopathies. This suggests two potential kinking types: stenotic and enlarged. A notable case presented bilateral Grade 3 internal carotid artery kinking, with right-sided stenosis and cerebral hypoperfusion, yet left-sided transient ischemic attacks occurred. This finding challenges existing classifications and suggests further investigation is warranted.

Keywords:Dolicoarteriopathies, Kinging, Carotid Artery.

Citation:

Dr. Mehmet Erkan Ustun, How Much We Know About Dolicoarteriopathies. World Neurosurgery Research 2025.