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[Dolichoarteriopathies (kinking, coiling, tortuosity) of carotid arteries and atherosclerotic disease: an ultrasonographic study].

The clinical significance of the dolichoarteriopathies (kinking, coiling and tortuosity) of the extracranial carotid arteries, their prognosis and etiopathogenesis have not yet been clearly defined. The aim of this study was to evaluate, by echo-color-Doppler, atherosclerotic lesions of carotids in subjects with, compared to those without dolichoarteriopathies. A total of 1220 subjects (aged 25-89 years), 316 with and 904 without dolichoarteriopathies, were studied. Patients were divided into 325 subjects without cardiovascular risk factors and 895 subjects with cardiovascular risk factors (352 with arterial hypertension alone, 298 with arterial hypertension associated with other cardiovascular risk factors, 245 with hypercholesterolemia, diabetes, cigarette smoking, alone or associated). Moreover, the study was performed specifically in a subgroup of 352 subjects with arterial hypertension without other cardiovascular risk factors. Myointimal thickness, as a mean of 5 measurements at the level of the common carotid, 2-3 cm from the flow-divider and plaques as a focal thickness > or = 2 mm, classified on the basis of echogenic characteristics (hard, fibrous, mixed, soft, hemorrhagic) and seat (bifurcation, common, internal and external carotid) were evaluated. In 316 patients with dolichoarteriopathies, compared to 904 patients without dolichoarteriopathies there were no differences in myointimal thickening (NS), the prevalence of carotid plaques was lower (p = 0.004) and there was no difference (NS) regarding ultrasonic characteristics (more frequently hard and less frequently fibrous, mixed and soft) and localization of plaques (more frequently at the level of the common and bifurcation and less frequently at the level of the internal and external carotid). In subjects without cardiovascular risk factors, myointimal thickness and carotid plaques did not show any significant differences (NS) in the group with compared to the without dolichoarteriopathies. On the contrary, either in subjects with cardiovascular risk factors, or in the subgroup with hypertension alone, myointimal thickening was equally represented (NS), while carotids with plaques were significantly less frequent (p = 0.002; p = 0.01) in the group with, compared to that without dolichoarteriopathies. In conclusion, dolichoarteriopathies of the carotids do not seem to be a consequence of atherosclerotic lesions but in the presence of cardiovascular risk factors or hypertension alone they may even prevent plaque formation.