@Article{crph6216,
AUTHOR = {Usman, Fritz Sumantri and Suryawijaya, Evlyne Erlyana and Yasa, I Made Mahardika and Hardiansyah, Hendra and Kastilong, Merlin Prisilia and Kurnia, Leny},
TITLE = {Determinants of the Carotid Tortuosity Index: Evidence from Digital Subtraction Angiography},
JOURNAL = {Current Research in Public Health},
VOLUME = {5},
YEAR = {2025},
NUMBER = {1},
PAGES = {80-87},
URL = {https://www.scipublications.com/journal/index.php/WJCMR/article/view/6216},
ISSN = {2831-5162},
DOI = {10.31586/wjcmr.2025.6216},
ABSTRACT = {Introduction: Stroke remains one of the leading causes of death and disability worldwide, with ischemic stroke accounting for most cases. Structural vascular factors such as carotid artery tortuosity have gained attention as potential markers of vascular aging and cerebrovascular risk. The carotid tortuosity index (CTI), defined as the ratio of actual vessel length to the straight-line distance between two fixed points, provides a quantitative measure of arterial curvature. A CTI value of ≥1.2 indicates pathological tortuosity. Although noninvasive modalities such as CTA and MRA are frequently used, digital subtraction angiography (DSA) remains the gold standard for evaluating vessel geometry due to its higher spatial precision. This study aimed to determine the association of age, sex, and hypertension with CTI measured by DSA. Methods: A cross-sectional study was conducted from November to December 2025 at the Neurointervention Clinic, RS Pelni Jakarta, Indonesia, involving 61 adult patients who underwent carotid DSA. CTI was measured bilaterally using digital imaging software and classified as <1.2 (non-tortuous) or ≥1.2 (tortuous). Clinical data, including age, sex, and hypertension status, were collected from medical records and analyzed using bivariate tests. Results: Older age (≥65 years), female sex, and hypertension were significantly associated with higher CTI values on both carotid sides. Tortuosity was more common among hypertensive patients and elderly females, indicating the influence of vascular remodeling and chronic hemodynamic stress. Conclusion: Carotid tortuosity increases with age, hypertension, and female sex. DSA-based CTI measurement provides a reliable and precise approach for evaluating vascular changes associated with cerebrovascular risk.},
}

%0 Journal Article
%A Usman, Fritz Sumantri
%A Suryawijaya, Evlyne Erlyana
%A Yasa, I Made Mahardika
%A Hardiansyah, Hendra
%A Kastilong, Merlin Prisilia
%A Kurnia, Leny
%D 2025
%J Current Research in Public Health

%@ 2831-5162
%V 5
%N 1
%P 80-87

%T Determinants of the Carotid Tortuosity Index: Evidence from Digital Subtraction Angiography
%M doi:10.31586/wjcmr.2025.6216
%U https://www.scipublications.com/journal/index.php/WJCMR/article/view/6216

TY  - JOUR
AU  - Usman, Fritz Sumantri
AU  - Suryawijaya, Evlyne Erlyana
AU  - Yasa, I Made Mahardika
AU  - Hardiansyah, Hendra
AU  - Kastilong, Merlin Prisilia
AU  - Kurnia, Leny
TI  - Determinants of the Carotid Tortuosity Index: Evidence from Digital Subtraction Angiography
T2  - Current Research in Public Health
PY  - 2025
VL  - 5
IS  - 1
SN  - 2831-5162
SP  - 80
EP  - 87
UR  - https://www.scipublications.com/journal/index.php/WJCMR/article/view/6216
AB  - Introduction: Stroke remains one of the leading causes of death and disability worldwide, with ischemic stroke accounting for most cases. Structural vascular factors such as carotid artery tortuosity have gained attention as potential markers of vascular aging and cerebrovascular risk. The carotid tortuosity index (CTI), defined as the ratio of actual vessel length to the straight-line distance between two fixed points, provides a quantitative measure of arterial curvature. A CTI value of ≥1.2 indicates pathological tortuosity. Although noninvasive modalities such as CTA and MRA are frequently used, digital subtraction angiography (DSA) remains the gold standard for evaluating vessel geometry due to its higher spatial precision. This study aimed to determine the association of age, sex, and hypertension with CTI measured by DSA. Methods: A cross-sectional study was conducted from November to December 2025 at the Neurointervention Clinic, RS Pelni Jakarta, Indonesia, involving 61 adult patients who underwent carotid DSA. CTI was measured bilaterally using digital imaging software and classified as <1.2 (non-tortuous) or ≥1.2 (tortuous). Clinical data, including age, sex, and hypertension status, were collected from medical records and analyzed using bivariate tests. Results: Older age (≥65 years), female sex, and hypertension were significantly associated with higher CTI values on both carotid sides. Tortuosity was more common among hypertensive patients and elderly females, indicating the influence of vascular remodeling and chronic hemodynamic stress. Conclusion: Carotid tortuosity increases with age, hypertension, and female sex. DSA-based CTI measurement provides a reliable and precise approach for evaluating vascular changes associated with cerebrovascular risk.
DO  - Determinants of the Carotid Tortuosity Index: Evidence from Digital Subtraction Angiography
TI  - 10.31586/wjcmr.2025.6216
ER  -