Absent right common carotid artery with stenting of symptomatic internal carotid artery stenosis

Abstract

Absent common carotid artery with independent origin of internal and external carotid arteries from the subclavian artery is a rare but recognized phenomenon. We describe one such case with an associated symptomatic proximal high-grade stenosis of the right internal carotid artery. The abnormal carotid anatomy was not initially well appreciated, resulting in a failed surgical exploration and subsequent successful endovascular carotid stenting. To our knowledge, this is the first reported case of carotid stent in a right internal carotid artery originating from the subclavian artery.

Congenital Aplasia of the Common Carotid Artery: A Comprehensive Review

“…We can support an earlier statement that the CCA aplasia had no significant le -right side preferences [7,43]; however, if only the cases of the known sex were taken into account, the cases of female gender were more common. e CCA aplasia was proven in one newborn [82], and in one neonate [56], but also in people at the age of 70 and above [7,18,21,25,53,60,63].…”

“…e ECA and ICA originated particularly from the NAA in 29/34 or 85.29% of the cases on the le , and in 24/41 or 58.53% of the cases on the right side. e patterns of the NAA branching were di erent in these cases; the number of these branches ranged from two [7,[52][53][54] to ve [18,[55][56][57]. Hovewer, the NAA with four branches was a more common nding associated with the le CCA aplasia [1,10,11,16,42,43,49,51,[58][59][60][61][62][63], than with the right [13,18,26] or bilateral CCA aplasia [38,64,65]; a pattern of the NAA with three branches was more common in the cases of the right CCA aplasia [5, 14, 15, 17-25, 27-29, 66], than in the cases of the le [67,68] or bilateral CCA aplasia [69] (Figure 5).…”

“…New branches from the ventral aspects of the right and le third PAAs form the right and le external carotid arteries (ECAs) which, in some instances, may include portions of the rst and second arch arteries [6]. e third PAA becomes the carotid sinus, and with the cranial DA forms the internal carotid artery (ICA), while the cranial ventral aorta becomes the ECA [7]. However, the root of the ECA can originate only from the proximal portion of the third PAA, which normally becomes the CCA [3].…”

“…If the DC persists, while the fourth PAA involutes, the third PAA could become the definitive arch of the aorta with separate ICA and ECA arising from it; when the anomaly is present on the right side, the ECA arises from the BT, whereas the ICA arises from the SA [5, 14−18], or both ECA and ICA could have separate origins from the BT [7,[19][20][21][22][23][24][25][26][27][28][29], or from the right SA [3].…”

“…In relation to the cases with known data, there was no associated pathology in 13/73 cases [1,11,16,18,23,26,28,43,49,51,59]. However, 21 various pathological states in other (60) cases were as follows: e amaurosis fugax [15], aneurysms of some cerebral arteries [24,31,42,52,53,58,61,62,67,71], arteriovenous stula [57], the carcinoma of the stomach [14], cerebral infarction [7,27,84], cervical spinal fusion [38], a cerebral vascular accident [25], a congenital cardiovascular anomaly [34,56,64,79,80,82,83], myocardial infarction [21], multiple block vertebrae [69], multiple sclerosis [22], Noonan syndrome [62], the occlusion of artery [5,7,63], parathyroid adenoma [60], posttraumatic artery dissection [29], pseudoaneurysm [57]…”