Tortuosity of the Internal Carotid Artery and Its Clinical Significance in the Development of Aneurysms

Tortuosity of blood vessels is a common angiographic finding that may indicate systemic disease and can be correlated with vascular pathologies. In this work, we determined whether patients with and without internal carotid artery (ICA) aneurysm presented with differences in its tortuosity descriptors. We retrospectively analysed data of 298 patients hospitalized between January 2014 and June 2018. For each patient's imaging data, we extracted a curve representing the ICA course and measured its Relative Length (RL), Sum of Angle Metrics (SOAM), Product of Angle Distance (PAD), Triangular Index (TI), and Inflection Count Metrics (ICM). We found that patients with an ICA aneurysm had significantly lower RL (0.46 ± 0.19 vs. 0.51 ± 0.17; <i>p</i> = 0.023) and significantly higher SOAM (0.39 ± 0.21 vs. 0.32 ± 0.21 <i>p</i> = 0.003), PAD (0.38 ± 0.19 vs. 0.32 ± 0.21; <i>p</i> = 0.011), TI (0.30 ± 0.11 vs. 0.27 ± 0.14; <i>p</i> = 0.034), and ICM (0.30 ± 0.16 vs. 0.22 ± 0.12; <i>p</i> < 0.001). We found that that patients who presented with a subarachnoid hemorrhage had significantly higher PAD (0.46 ± 0.22 vs. 0.35 ± 0.20; <i>p</i> = 0.024). In conclusion, higher tortuosity of ICA is associated with ICA aneurysm presence.