Definition: A tortuous vessel is a blood vessel that exhibits abnormal twisting, looping, or excessive curvature, deviating from its expected anatomical path. Tortuosity can affect both arteries and veins and may be congenital or acquired.

Clinical implications:

• Increases technical difficulty during endovascular procedures.
• May contribute to altered hemodynamics, stenosis, or flow limitation.
• Commonly seen in elderly patients or those with hypertension, arterial elongation, or vascular malformations.

Imaging and diagnosis:

• Digital subtraction angiography (DSA)
• Computed tomography angiography (CTA)
• Magnetic resonance angiography (MRA)
• 3D reconstruction in neurovascular planning

Common locations:

• Internal carotid artery
• Vertebral artery
• Sigmoid/transverse sinus
• Retinal vessels

Related terms:

• trackability
• steerability
• vascular elongation
• stenosis