Carotid endarterectomy for stenoses of twisted carotid bifurcations

Twisted carotid bifurcations were preferentially found in right severely atherosclerotic carotids in patients with diabetes mellitus and/or hypertension. Carotid endarterectomy of twisted carotids can be safely accomplished, sometimes with correction of the carotid position. Multidetector computed tomography angiography was useful for perioperative evaluation. Variation should be considered by the neurosurgeon and neurologists concerned in the evaluation and treatment of carotid stenoses.