title: Endothelial dysfunction in carotid elongation.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Neurological Sciences, University of Padua, School of Medicine. claudiobaracchini@tin.it
authors.forename: Claudio
authors.initials: C
authors.lastname: Baracchini
authors.forename: Filippo
authors.initials: F
authors.lastname: Farina
authors.forename: Simone
authors.initials: S
authors.lastname: Tonello
authors.forename: Valentina
authors.initials: V
authors.lastname: Citton
authors.forename: Giorgio
authors.initials: G
authors.lastname: Meneghetti
authors.forename: Enzo
authors.initials: E
authors.lastname: Ballotta
authors.forename: Renzo
authors.initials: R
authors.lastname: Manara
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000503:physiopathology*; D002339:Carotid Arteries / Q000002:abnormalities* / Q000503:physiopathology*; D055119:Elastic Modulus; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D014655:Vascular Resistance; D014664:Vasodilation