Anomalous External Carotid Artery-Internal Carotid Artery Anastomosis in Two Patients with Proximal Internal Carotid Arterial Remnants

Kim, Chang Hun; Cho, Young Dae; Kang, Hyun-Seung; Kim, Jeong Eun; Jung, Sung Eun; Ahn, Jun Hyong; Han, Moon Hee

doi:10.3348/kjr.2015.16.4.914

Cited by 15 publications

(24 citation statements)

References 10 publications

(16 reference statements)

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“…First, nearly all extracranial branches of the NBCA indicate identical courses to the healthy branches derived from the ventral pharyngeal artery and stapedial artery, which are the primitives of ECA [ 1 , 2 , 4 , 5 ]. Second, the proximal course of most NBCAs resembles that of the ECA, and the tortuosity at the C1 to C2 level suggests a connection with the primitive ECA and ICA [ 2 , 6 ]. These features support the hypothesis that an NBCA develops from agenesis of the proximal ICA, with an anastomosis of the distal ECA and ICA.…”

Section: Discussionmentioning

confidence: 99%

Nonbifurcating Carotid Artery: A Case Report with a Review of Embryogenesis

Lai

2018

Am J Case Rep

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Patient: Male, 66Final Diagnosis: Nonbifurcating carotid arterySymptoms: No symptomsMedication: —Clinical Procedure: —Specialty: NeurologyObjective:Congenital defects/diseasesBackground:Vascular anomalies of the carotid vessels can be attributed to false embryogenesis. A rare variant called a nonbifurcating carotid artery (NBCA) exists, where typical carotid bifurcation is not recognizable with its typical branches of the external carotid artery (ECA) and internal carotid artery (ICA). This paper describes a case of this anomaly and reviews the embryogenesis of the carotid arteries for explanation.Case Report:A 66-year-old man received a routine health examination at our hospital. Initial carotid ultrasound indicated an absence of bifurcation in the right cervical carotid artery, and magnetic resonance imaging of the brain indicated an absence of the proximal cervical segment of the right ICA, with a remnant arterial stump at the expected bifurcation level. No evidence of the carotid bulb was identified. The common carotid artery seemed to continue cranially in the trunk of the ECA, where it exhibited extracranial branches. After distributing these branches, the carotid artery coursed medially at the C2 level, where it ascended into the carotid canal to become the petrosal segment of the ICA. This carotid anomaly was labelled an NBCA. No aberrant intracranial arteries were derived from the NBCA in this case.Conclusions:In this case, the arterial stump was considered a remnant from agenesis of the right ICA. We assumed that the NBCA most likely developed because of false regression of the third embryogenic aortic arch with persistence of the second aortic arch.

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Section: Discussionmentioning

confidence: 99%

Nonbifurcating Carotid Artery: A Case Report with a Review of Embryogenesis

Lai

2018

Am J Case Rep

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“…Rare cases of nonbifurcating carotid artery with origin of ICA found at C2 or C1 level and branches of ECA originating from nonbifurcating carotid artery indicate that persistence of primitive hyoid-stapedial system can substitute normal development in case of embryologic arrest. Notably those variations can go unnoticed through lifetime as they are asymptomatic and their connection to diseases (e.g., atherosclerosis and stroke) is unclear [ 8 ]. Different and largely unknown mechanisms including duplication or regression of primitive vessels have been proposed to explain anatomical variability in the area [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Notably those variations can go unnoticed through lifetime as they are asymptomatic and their connection to diseases (e.g., atherosclerosis and stroke) is unclear [ 8 ]. Different and largely unknown mechanisms including duplication or regression of primitive vessels have been proposed to explain anatomical variability in the area [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Anatomical Considerations on Surgical Anatomy of the Carotid Bifurcation

Michalinos

Chatzimarkos

Arkadopoulos

et al. 2016

Anatomy Research International

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Surgical anatomy of carotid bifurcation is of unique importance for numerous medical specialties. Despite extensive research, many aspects such as precise height of carotid bifurcation, micrometric values of carotid arteries and their branches as their diameter, length, and degree of tortuosity, and variations of proximal external carotid artery branches are undetermined. Furthermore carotid bifurcation is involved in many pathologic processes, atheromatous disease being the commonest. Carotid atheromatous disease is a major predisposing factor for disabling and possibly fatal strokes with geometry of carotid bifurcation playing an important role in its natural history. Consequently detailed knowledge of various anatomic parameters is of paramount importance not only for understanding of the disease but also for design of surgical treatment, especially selection between carotid endarterectomy and carotid stenting. Carotid bifurcation paragangliomas constitute unique tumors with diagnostic accuracy, treatment design, and success of operative intervention dependent on precise knowledge of anatomy. Considering those, it becomes clear that selection and application of proper surgical therapy should consider anatomical details. Further research might ameliorate available treatment options or even lead to innovative ones.

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“…Carotid stump syndrome remains a rare entity, but it is a treatable cause of recurrent retinal and hemispheric symptoms after ICA occlusion. Rarely, after complete occlusion of the ICA, a short patent portion of the proximal ICA can be shown by angiography as well as by other imaging modalities, and is referred to as the “carotid stump.” In this case, congenital non-bifurcating CCA with an anomalous ECA-ICA connection, rather than acquired ICA occlusion could be the cause of the carotid stump [ 2 ].…”

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confidence: 99%