What Is a Tortuous Artery?

Tortuous arteries take winding, twisting paths

A tortuous artery is one that twists and winds in a "tortuous" path. Tortuous arteries may be genetic or caused by other health conditions, such as thickening of the arteries or simple aging. Tortuous arteries are usually only noted when they begin to cause problems, and they pose many health risks.

Arteries vs. Veins

Artery walls have a flexible muscular layer.

Arteries are very elastic, are much more resilient than veins and are less likely to be tortuous. Arteries carry blood away from the heart, and veins carry blood back to the heart. This difference in blood pressure means that veins require thinner walls than arteries, according to the Merck Manual, a medical textbook. Blood backflow through valves can easily stretch vein walls, causing them to bulge and become convoluted. Varicose veins are examples of tortuous veins.

Vascular Disease

Hypertension can weaken blood vessel walls.

When arteries take a winding and wandering path, it is a symptom of vascular disease. Radiologists Venkatraman Bhat and Ahmed Al Muzrakchi explain that tortuous arteries signal atherosclerosis or hypertension in the aging population: The thickening of arteries or high blood pressure can force arteries to pave alternate twisted pathways. In children, tortuous arteries can be a sign of an underlying systemic disease. The radiologists say that screening for such blood vessels can often lead to the diagnosis of other serious conditions.

Genetics and Tortuous Arteries

Torturous arteries have a strong genetic component.

A 2008 study published in the British Journal of Ophthalmology found that in healthy twins with different lifestyles, the development of tortuous arteries in the retina could be attributed to genetic influences 82 percent of the time. Men and those with a family history of such blood vessels are much more likely to experience aneurysms and blood clots because of tortuous arteries. Dr. Simon Dodds, a vascular disease researcher, says that so far there is no evidence that lifestyle changes make any difference in changing the risk of such aneurysms.

Aneurysmal Arterial Disease

Most tortuous arteries go undetected until serious complications occur.

Aneurysmal arterial disease occurs when arteries become stretched and bent over time. Dr. Simon Dodds explains that deficiencies in the normal ongoing repair of arteries causes this development, and blood tends to pool and clot in certain regions and bends of the arterial pathway. This can lead to arterial aneurysms and is more likely in the aging population, males, people with high blood pressure and those with a family history of the condition.

There are usually no warning symptoms for this slow and progressive condition, says Dodds, until serious complications such as rupture or arterial blockage occur.

Tortuous Arteries Complicate Medical Procedures

Winding blood vessels make some surgeries difficult and dangerous.

The Radiology Department of University Hospitals in Cleveland warns that CT scans can often depict dense tortuous artery regions as solid masses. The looping and winding of such arteries can lead physicians to attempt to take a biopsy of what they may consider a tumor.

Another serious issue that tortuous arteries present is how difficult they make surgeries meant to open or widen blocked arteries. There is always a danger that a surgeon may puncture or perforate the arterial wall when vessels are extremely winding and constructed of thinner walls.

The "accordion effect" refers to the crumpling of tortuous arteries during diagnosis and treatment of arterial blockages. Japanese researchers describe such difficulties in a case they published in the 2006 issue of Neuroradiology. The crumpling of the artery by a lead wire appeared as a lesion but was due to the intervention itself. When the catheter was withdrawn from the artery, the supposed lesion disappeared.

Tortuous arteries can complicate both diagnosis and treatment of various conditions.

References

• "Heart Views"; Meandering Vessels: A Sign of Arterial Tortuosity on Plain Chest Radiography; Venkatraman Bhat and Ahmed Al Muzrakchi; March to May 2008
• "British Journal of Ophthalmology"; Straight versus tortuous retinal arteries in relation to blood pressure and genetics; NCBB Taarnhøj; May 10, 2008
• Merck Manual; Blood Vessels
• S.R. Dodds; Aneurysmal Arterial Disease; SR Dodds; (2001)
• "Neuroradiology"; Accordion Effect During Carotid Artery Stenting; Masanori Tsutsumi; March 7, 2007