The elongation of the internal carotid artery. Diagnosis and surgical treatment.

Cerebro-vascular insufficiency is rarely caused by an abnormal elongation of the internal carotid artery (the ratio is 15% to 17% of symptomatic patients). The anomalies can be defined as: tortuosity, when the artery has a "C" or "S" shape; coiling, when the elongation is more evident and the artery forms one or more loops; kinking, when there is a sharp angulation of the first portion of the internal carotid artery. The etiology of these peculiar arterial modifications seems to be related to a congenital basis which may become exaggerated with ageing of the artery. Surgical correction should include intra-arterial inspection (TEA) as well as eliminating the pathological elongation. The Authors presents their 9 cases surgical experience.