Surgical correction of pathological tortuosities of internal carotid arteries: current state of the problem

Pathological tortuosity-elongation of the carotid arteries with the formation of kinks (so-called septal stenoses), up to complete loops at 360°. In the development of ischemic brain disorders, pathological tortuosity of the carotid arteries takes the second place after atherosclerotic lesions. Currently, there are many unsolved problems in their treatment. The etiological factors, indications for surgery, evaluation of the effectiveness and choice of tactics of surgical interventions have not been fully studied. This review presents the current aspects of etiology, classification, indications and methods of surgical interventions. Modern methods of diagnosis and evaluation of cerebral ischemia are demonstrated, data on laboratory markers of ischemia are collected, and methods of intraoperative protection of the brain in resections of tortuosity of the internal carotid arteries are shown.