Carotid artery tortuosity morphometric analysis and impact on technical aspects of mechanical thrombectomy in acute ischemic stroke patients OBJECTIVES: The objective of this study was to analyze the morphometric characteristics of the carotid arteries of patients with acute ischemic stroke and to examine the relationship between the tortuosity of the carotid arteries with the technical aspects of mechanical thrombectomy, as well as with the patients' demographic and clinical characteristics and treatment outcome. STUDY DESIGN: A cross-sectional study with historical data examining the incidence of carotid artery tortuosity, technical aspects of mechanical thrombectomy, and treatment outcome in patients with acute ischemic stroke treated with mechanical thrombectomy. PARTICIPANTS AND METHODS: The study included 84 patients with occlusion of the M1 segment of the middle cerebral artery treated by mechanical thrombectomy. RESULTS: The majority of of patients had some form of tortuosity. Time from arterial puncture to the first attempt of thrombus extraction was significantly shorter in patients with a nontortuous carotid artery compared to a tortuous one (P = 0.006). There were no significant differences in the number of attempts, the total duration of the procedure and the difference in NIHSS score before and after the procedure with regard to the form of tortuosity. Patients with arterial hypertension had significantly higher tortuosity index values compared to those without arterial hypertension (P = 0.008), patients with nontortuous carotid tree were significantly younger compared to all forms of tortuosity (P = 0.003). CONCLUSION: The majority of patients with acute stroke had tortuous carotid arteries, and a higher index of tortuosity was associated with a longer time from puncture to the first attempt of thrombus extraction. Older age and arterial hypertension are risk factors for the development of tortuosity, and the tortuosity index was not related to the outcome of treatment.