Carotid Artery Stenting for Atherosclerotic Stenosis Associated With Non-bifurcating Cervical Carotid Artery

Abstract

A 68-year-old man presented with right cervical carotid artery stenosis manifesting as ipsilateral amaurosis fugax. Angiography showed non-bifurcating cervical carotid artery with atherosclerotic stenosis near the branching of the superior thyroid artery. Carotid artery stenting (CAS) was carried out using two balloons for embolic protection of the internal carotid artery and middle meningeal artery because the ophthalmic artery was supplied by the middle meningeal artery. No procedure-related complications or restenosis occurred after stenting. Non-bifurcating cervical carotid artery is a very rare anomaly, in which the branches of the external carotid artery directly arise from the common trunk of the carotid artery without forming a bifurcation. The present patient was successfully treated with CAS for atherosclerotic stenosis associated with non-bifurcating cervical carotid artery.

Morphological variation of carotid artery bifurcation level in digital angiography

“…The variations of the carotid artery have been usually studied in cadaver studies, and carotid angiographic studies, and there are also some case reports of variations determined during neck surgery [10,11,16,21,24]. Our research is an angiographic variation study performed on 100 patients.…”

An Anatomical Variation in the Cervical Carotid Artery of a Young Stroke Patient

“…While there are several reports on non-bifurcating arteries, there is only one reported case of a non-bifurcating artery with protrusion of a remnant ICA (14). This is the second report of this anatomical variation, but it is the first report to describe this anatomical variation as a cause of stroke.…”

“…In addition, no temporal changes could be detected in the findings because MRI of the plaque was not performed on an outpatient basis, while computed tomography (CT) angiography and US were performed. However, according to previous studies, the high signal intensity on T1-weighted MR carotid plaque imaging, which is considered to be the least invasive method for evaluating plaque components, suggested the presence of thrombi, including a hemorrhagic component (14,15). Second, all appropriate examinations for detecting the embolic sources of stroke in this patient were performed, with the exception of an insertable cardiac monitor (ICM), which had not yet been introduced and which was not available to us.…”

Angiographic Features of Unilateral Nonbifurcating Cervical Carotid Artery: A Case Report

“…The nonbifurcating cervical carotid artery is a rare disease en- er, appropriate diagnosis is necessary to avoid complications, such as embolic infarctions during interventional radiologic procedures or head and neck surgeries (1,5).…”