scholarly journals Eversion carotid endarterectomy with nerve-sparing component in a case of high location of common carotid artery bifurcation

2021 ◽  
Vol 25 (3) ◽  
pp. 94
Author(s):  
I. V. Makarov ◽  
A. S. Borisenkov ◽  
I. A. Migunov
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Common Carotid Artery ◽  
Preoperative Evaluation ◽  
Cranial Nerves ◽  
Hospital Medicine ◽  
Nerve Sparing ◽  
Left Internal Carotid Artery ◽  
Brachiocephalic Trunk ◽  
The Right

<p>We performed carotid endarterectomy on a patient with 75% stenosis of the left internal carotid artery (ICA), 70% stenosis of the left common carotid artery (CCA), 60% stenosis of the right ICA and 55% stenosis of the right CCA after a transient ischaemic attack on the premises of the surgical unit of Russian Railways Hospital–Medicine (Samara), which is the clinical site for the care of surgical diseases at Samara State Medical University. During the preoperative evaluation and physical examination, we determined that the chance of high CCA bifurcation was high because the patient had a brachymorphic physique and his neck was short and broad. In fact, during the surgical exploration of the carotid triangle area, the CCA bifurcation was identified 7 ± 0.5 cm higher than the shield-like cartilage rim; thus the CCA bifurcation area crossed the stems of the glossopharyngeal (IX), vagus (X) and hypoglossal (XII) nerves, which precluded classic carotid endarterectomy. We then decided to perform carotid endarterectomy, using the eversion method and transposing the ICA above the rami of the cranial nerves. Through this method, we minimised traction and nerve stem trauma during the process of reconstructing brachiocephalic trunk arteries, prevented morbidities involving the cranial nerves during postsurgical period, accelerated the patient’s recovery and improved the patient’s quality of life. With further patient monitoring during the early and late postoperative periods, no abnormalities of peripheral innervation occurred.</p><p>Received 26 March 2021. Revised 6 May 2021. Accepted 11 May 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflicts of interests.</p><p><strong>Contribution of the authors:</strong> The authors contributed equally to this article.</p>

scholarly journals An unusual origin of the right subclavian artery – arteria lusoria

2014 ◽  
Vol 27 (4) ◽  
pp. 234-236
Author(s):  
Agnieszka Mocarska ◽  
Miroslaw Szylejko ◽  
Elzbieta Staroslawska ◽  
Franciszek Burdan
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Left Common Carotid Artery ◽  
Left Vertebral Artery ◽  
Anatomical Anomaly ◽  
Arteria Lusoria ◽  
Brachiocephalic Trunk ◽  
The Right

Abstract The aortic arch usually gives off three major arterial branches: the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. The most frequently occurring developmental variations of arterial trunks origins are a joined brachiocephalic and left common carotid artery origin, the left vertebral artery branching from the aortic arch, a double aortic arch, and a change of sequence of branching arteries. The current report presents the rare asymptomatic situation of the right subclavian artery originating as the last individual branching from the aortic arch. This abnormality was accidentally discovered in a computed tomography examination of a 69-year old male patient. The examination showed that the artery went towards the neck posteriorly from the trachea. The anatomical anomaly was interpreted as being an arteria lusoria.

scholarly journals An Important Clue in the Sonographic Diagnosis of Internal Carotid Artery Agenesis: Ipsilateral Common Carotid Artery Hypoplasia

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Omer Kaya ◽  
Cengiz Yilmaz ◽  
Bozkurt Gulek ◽  
Gokhan Soker ◽  
Gokalp Cikman ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
Radiology Department ◽  
Left Internal Carotid Artery ◽  
Doppler Us ◽  
Healthcare Center ◽  
Important Clue ◽  
The Right

A 42-year-old female patient, who had been diagnosed with an occlusion of her left internal carotid artery (ICA) following Doppler ultrasonographic (US) and digitally-subtracted angiographic (DSA) examinations performed in an outer healthcare center in order to eliminate the underlying cause of her complaint of amorosis fugax, later applied to our hospital with the same complaint. At Doppler US performed in our hospital’s radiology department, her right common carotid artery (CCA) was normal, but her left CCA was hypoplastic. The right internal artery (ICA) was validated as normal. At the left side, however, the ICA was apparent only as a stump and it did not demonstrate a continuity. The diagnosis of ICA agenesis was confirmed by the utilization of Doppler US, CT, and DSA imaging, and it was concluded also that ipsilateral CCA hypoplasia could be evaluated as an important clue to the diagnosis of ICA agenesis.

scholarly journals Morphometry of the aortic arch and its branches

2013 ◽  
Vol 19 (3) ◽  
pp. 154-159 ◽  
Author(s):  
A.M. Manole ◽  
D.M. Iliescu ◽  
A. Rusali ◽  
P. Bordei
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Left Subclavian Artery ◽  
Ascending Aorta ◽  
Ct Scanner ◽  
Arterial Trunk ◽  
Brachiocephalic Trunk ◽  
The Right

Abstract Our study was conducted by the evaluation of angioCT’s performed on a GE LightSpeed VCT64 Slice CT Scanner. The measurements were performed on the aortic arch at the following levels: at the origin of the aorta, the middle part of the ascending aorta, prior to the origin of the brachiocephalic arterial trunk and after the origin of the left subclavian artery. We measured the caliber of the aortic arch arteries and the data are correlated and reported by gender. The diameter of the ascending aorta was between 27 to 28.9 mm in females and in males from 25.8 to 37.6 mm. The diameter of the aorta within the middle segment of the ascending part was between 28-30.2 mm in females and in males from 26.1 to 34.6. The diameter of the aortic arch prior to the origin of the brachiocephalic arterial trunk was between 26.4 to 29.4 mm in females and in males from 25.8 to 37.5 mm. The diameter of the aortic arch after the origin of the left subclavian artery was in a range of 20.4 to 28.4 mm, which corresponds to the limits found in males while in females the aortic diameter was between 21.3 to 24.1 mm. The brachiocephalic trunk diameters were 8.3 to 15.5 mm in females and in males was 9.1 to 14.5 mm. The right common carotid artery had a diameter of 4-8 mm diameter in males and in females ranged from 4.7 to 5.5 mm. The right subclavian artery showed a caliber of 5.7 to 7.5 mm in females and in males from 5.9 to 10.1. The left common carotid artery diameter was 4.6 to 5.7 mm in females and males the diameter was between 5.2 to 7.4 mm. The left subclavian artery had a diameter of 6-10 mm in females and in males ranged from 7.7 to 12.8 mm. We found that the distance between the ascending part of the aorta and the descending segment ranged from 33.3 to 38.5 mm in females and in males from 40 to 68.6 mm. We measured the distance that exists at the crossing of the aortic arch with the left branch of the pulmonary trunk, finding that in females this distance is 3 to 10.3 mm and in males from 3 to 12.5 mm.

scholarly journals Challenges in Managing Massive Neck Pseudoaneurysm

2021 ◽  
Author(s):  
Bharath V. ◽  
Sumit Agasty ◽  
Milind Padmakar Hote
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Emergency Surgery ◽  
Preoperative Evaluation ◽  
Operation Room ◽  
Impending Rupture ◽  
Interventional Management ◽  
The Right

AbstractPseudoaneurysms in the neck are challenging surgical cases. They need detailed preoperative evaluation, treatment of etiology, and surgical/interventional management at appropriate time.Here, we describe a case of 45-year-old female who presented to emergency with impending rupture of swelling in the right side of neck. On evaluation, it was found to be a pseudoaneurysm of right common carotid artery (RCCA). She was planned for emergency surgery, but the swelling ruptured before the patient could be taken into the operation room (OR). The challenges faced in managing it are described below.

scholarly journals Mechanical Thrombectomy Using Transradial Access in a Variation of the Origin of the Brachiocephalic Trunk and Left Common Carotid Artery by the Common Ostium from the Aortic Arch

2020 ◽  
Vol 101 (2) ◽  
pp. 126-130
Author(s):  
B. M. Sharafutdinov ◽  
S. A. Ryzhkin ◽  
E. A. Gaziev ◽  
I. V. Abdul’yanov ◽  
A. R. Abashev ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Left Common Carotid Artery ◽  
Stent Retriever ◽  
Left Internal Carotid Artery ◽  
Left Middle Cerebral Artery ◽  
Transradial Access ◽  
Brachiocephalic Trunk ◽  
The Common

The paper describes a clinical case of successfully applying a transradial access during mechanical thrombus extraction in a patient in the acutest stage of ischemic stroke with a congenital anatomical feature (the left common carotid artery and brachiocephalic trunk with the common ostium from the aortic arch).X-ray endovascular interventions were performed in an operating room equipped with a digital angiographic unit including an Axiom Artis dTA flat detector (Siemens Medical System).Mechanical recanalization for acute occlusion of the M2 segment of the left middle cerebral artery (MCA) was carried out using a right radial access into and catheterization of the left internal carotid artery. A stent retriever was inserted into the occlusion area through a microcatheter and was opened. Double thrombus extraction from the left MCA was made using the stent retriever to restore TICI 2B blood flow. There were no signs of dissection, thrombosis, or distal thromboembolism.

scholarly journals The arteries originating from the aortic arch and the patterns of their branches in ground squirrels (Spermophilus citellus)

2011 ◽  
Vol 56 (No. 9) ◽  
pp. 469-472
Author(s):  
A. Aydin ◽  
ZE Ozkan ◽  
S. Yilmaz ◽  
R. Ilgun
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Axillary Artery ◽  
Ground Squirrels ◽  
Red Squirrels ◽  
Brachiocephalic Trunk ◽  
Spermophilus Citellus ◽  
The Right ◽  
External Face

&nbsp; &nbsp;In this study, the aim was to investigate the anatomy of the aortic arch in ground squirrels (Spermophilus citellus). Five ground squirrels were investigated. The materials were carefully dissected and the arterial patterns of arteries originating from the aortic arch were examined. The brachiocephalic trunk and the left subclavian artery were separated from the aortic arch. The brachiocephalic trunk first gave the left common carotid artery, and then the right subclavian and common carotid artery detached from it. In all the animals examined, at the cranial thoracic entrance and after leaving from this entrance, similar branches arising from the left and right subclavian arteries were the common branch of the internal thoracic artery and the intercostal suprema artery, separate branches as the vertebral and descending scapular arteries and a common branch of the cervical superficial, the cervical profund, the suprascapular arteries and the spinal ramus. After separation of these branches, the continuation of the artery gave the external thoracic artery on the external face of the thoracic cavity and then formed the axillar artery. The axillary artery separated into the subscapular and the brachial arteries. In conclusion, the pattern of arteries originating from the aortic arch and the branches of these arteries were partially similar to what has been observed in red squirrels, and thus differ from other rodents and domestic mammals. &nbsp;

scholarly journals The arteries originating from the aortic arch and the branches of these arteries in red squirrels (Sciurus vulgaris)

2011 ◽  
Vol 56 (No. 3) ◽  
pp. 131-134 ◽  
Author(s):  
A. Aydin
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Left Subclavian Artery ◽  
Axillary Artery ◽  
Thoracic Cavity ◽  
Sciurus Vulgaris ◽  
Brachiocephalic Trunk ◽  
The Right

This study had the aim of investigating the anatomy of the aortic arch in squirrels (Sciurus vulgaris). Ten squirrels were studied. The materials were carefully dissected and the arterial patterns of arteries originating from the aortic arch were examined. The brachiocephalic trunk and the left subclavian artery were detached from the aortic arch. The brachiocephalic trunk first gave the left common carotid artery, and then detached to the right subclavian and common carotid artery. In all the examined materials, the left and right subclavian arteries gave branches that were similar after leaving the thoracic cavity from the cranial thoracic entrance. But while the whole branches of the the right subclavian artery were arising from almost the same point the left subclavian artery gave these branches in a definite order, and the branches that separated were the following: the internal thoracic artery, the intercostal suprema artery, the ramus spinalis, the vertebral artery and the descending scapular artery. It also gave the common branch formed by the junction of three of the cervical superficial, the cevical profund and the suprascapular arteries. After the separation of these branches, continuation of the artery gave the external thoracic artery on the external face of the thoracic cavity and then formed the axillar artery. The axillary artery separated into the subscapular and the brachial arteries. Thus, the arteries originating from the aortic arch and the branches of these arteries are different from other rodents and from domestic mammals.

Endarterectomy for a symptomatic carotid web

Vascular ◽  
2017 ◽  
Vol 25 (5) ◽  
pp. 553-556 ◽  
Author(s):  
John Phair ◽  
Eric B Trestman ◽  
Chetra Yean ◽  
Evan C Lipsitz
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Common Carotid Artery ◽  
Filling Defect ◽  
Acute Onset ◽  
Uneventful Recovery ◽  
Symptomatic Carotid ◽  
Unclear Etiology ◽  
The Right

Background We report a symptomatic carotid web successfully treated with carotid endarterectomy. A healthy 43-year-old woman presented with acute-onset left-sided weakness. Carotid web was evident on computed tomography angiography as a focal filling defect in the right common carotid artery. This right common carotid artery web extended into the ICA created an eddy resulting in turbulent flow. Subsequent acute embolus formation led to embolization and acute stroke. Method Review of the literature was performed using Medline Plus and PubMed databases. Result The patient underwent carotid endarterectomy with primary closure. Procedure was well tolerated and there was an uneventful recovery. Conclusion Arterial webs are a rare arteriopathy and a usual arrangement of fibromuscular intralumenal in-growth with unclear etiology. It is however, an important potential etiology of stroke in patients without traditional atherosclerotic risk factors. Carotid web and atypical carotid fibromuscular dysplasia should be considered in young, otherwise healthy patients presenting with stroke and without the typical risk factors for atherosclerotic carotid disease and stroke.

scholarly journals TOPOGRAFIA DOS COLATERAIS CALIBROSOS DO ARCO AÓRTICO DE UM MÃO - PELADA (Procyon cancrivorus – GRAY, 1865) (CARNIVORA – PROCYONIADAE)

2004 ◽  
Vol 9 (2) ◽  
Author(s):  
A.L.Q. SANTOS ◽  
F.M. MORAES ◽  
T.S. MALTA ◽  
S.F.M. CARVALHO ◽  
J.R.F. ALVES JUNIOR
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Internal Thoracic Artery ◽  
The Third ◽  
Arterial Blood ◽  
First Rib ◽  
Brachiocephalic Trunk ◽  
The Right

Estudou-se a topografia dos colaterais calibrosos do arco aórtico em um exemplar de Procyon cancrivorus, adulto, macho, proveniente da Fazenda Experimental do Glória, da Universidade Federal de Uberlândia, MG, Brasil, o qual teve seus vasos arteriais injetados com solução corada de Neoprene Latex “450”, com posterior fixação em solução aquosa de formol a 10% e submetidos à dissecação. O arco aórtico encontra-se em correspondência à terceira costela, no antímero esquerdo da cavidade torácica. O primeiro ramo calibroso do arco aórtico é o tronco braquiocefálico, situado medialmente à terceira costela, originando as artérias carótida comum esquerda, carótida comum direita e a subclávia direita, em correspondência ao primeiro espaço intercostal. A artéria subclávia esquerda é o segundo ramo emergente do arco aórtico, originando-se medialmente à terceira costela. As artérias subclávias direita e esquerda, cedem os mesmos colaterais em ambos os antímeros, ou seja, tronco costocervical esquerdo (medialmente à primeira costela), tronco costocervical direito (borda cranial da primeira costela), artérias cervical superficial esquerda e cervical superficial direita (borda cranial da primeira costela), artéria torácica interna esquerda (medialmente à segunda costela) e artéria torácica interna direita (borda cranial da primeira costela). The topography of the thick collaterals of the aortic arch in a crab – eating raccoon Procyon cancrivorus – Gray, 1865, Carnivora – Procyoniadae Abstract An anatomical study has been carried out on the topography of the thick collateral branches of the aortic arch in an adult male specimen of raccoon (Procyon cancrivorus) from the Gloria Experimental Farm, Federal University of Uberlandia MG, Brasil. For this purpose, the arterial blood vessels were injected with a ruddy solution of Neoprene Latex “450”, fixed by means of a 10% aqueous solution of formaldehyde and then dissected. It has been observed that the aortic arch is in correspondence with the third rib at the left side of the thoracic cavity The first thick branch of the aortic arch is the brachiocephalic trunk which is situaded medially in regard to the third rib, originating the left common carotid artery, the right common carotid artery and the right subclavian artery in correspondence with the first intercostal space. The left subclavian artery is the second emerging branch of the aortic arch originating itself medialy to the third rib. The right and the left subclavian arteries give way to the same collaterals in both sides, as the left costocervical trunk (medially to the first rib), the right costocervical trunk (cranial edge of the first rib), the left and the right superficial cervical arteries (cranial edge of the first rib, the left internal thoracic artery (medially to the second rib), and the right internal thoracic artery (cranial edge of the first rib).

Anomalous innominate artery complicating tracheal surgical procedures

2021 ◽  
pp. 1-4
Author(s):  
J J E Sargunaraj ◽  
R R Paul ◽  
S S Mathews ◽  
R R A Albert
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Neck Region ◽  
Innominate Artery ◽  
Accidental Injury ◽  
Tracheal Surgery ◽  
Computed Tomography Images ◽  
Brachiocephalic Trunk ◽  
Lower Neck ◽  
The Right

Abstract Objective To highlight the importance of imaging in reducing an accidental injury to the anomalous brachiocephalic trunk and its branches during tracheal surgery. Case report This paper reports two cases of accidental injury to the great vessels in the neck during tracheal surgery. The first incident occurred during a repeat tracheostomy, when the right common carotid artery was injured. On reviewing the computed tomography images, the bifurcation of the brachiocephalic artery was seen to the left of the midline, and the right common carotid artery was adherent just below the tracheostomy site. The second incident happened during surgery for tracheal stenosis, when there was an inadvertent injury to the main brachiocephalic trunk, which was adherent to the trachea in the lower neck region. Conclusion For airway surgeons, radiological assessment of vascular structures in relation to the trachea prior to surgery is as important as the endoluminal airway assessment for the best outcome.

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