Anatomical Variations of the Right Internal Carotid Artery: A Cross-sectional Computed Tomography Angiography Study in High-altitude Population

Abstract Background: The internal carotid artery (ICA) is vital for cerebral circulation, making its anatomical integrity crucial for normal neurological function. Variations in the right ICA are particularly important, as they may alter cerebral hemodynamics, influence perfusion patterns, and modify individual risk for cerebrovascular events, yet data specific to Kashmiri population remain limited. Methodology: In this cross-sectional study, computed tomography angiography scans of 216 adult Kashmiri residents were analyzed from January 2023 to July 2024. Statistical analysis included Chi-square tests, multivariate logistic regression, and odds ratio calculations to assess various anatomical variations. Results: Anatomical variations were observed in 23.1% of participants (95% confidence interval: 20.4%–25.8%). Gender analysis revealed higher variation rates in females (26.1%) compared to males (21.0%) ( P = 0.004). Age-stratified analysis showed increasing variation rates with age: 14.5% in 20–40 years, 28.1% in 41–60 years, and 29.7% in >60 years ( P < 0.001). Multivariate analysis identified significant associations between age and tortuosity ( P < 0.001). Caliber variations included hypoplasia (11.1%) and dilatation (4.6%), with higher rates of hypoplasia in older age groups (16.2% in >60 years, P = 0.004). Conclusion: This study demonstrates significant demographic correlations with RICA variations in the Kashmiri population, with notably higher rates compared to other global populations. The findings suggest possible genetic or environmental factors specific to the region, particularly related to high-altitude adaptation. These results have important implications for surgical planning and risk assessment in this population, warranting consideration in clinical practice.