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2.
Surg Radiol Anat ; 46(5): 659-663, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38418595

RESUMEN

PURPOSE: Various variations in the head and neck vasculature have been reported. The purpose of this report is to describe an extremely rare case of thyrolinguofacial trunk (TLFT) arising from the common carotid artery (CCA). METHODS: A 66-year-old woman with vertigo, dizziness, and heaviness in the head underwent computed tomography (CT) angiography of the neck and head region for evaluation of cerebrovascular diseases. RESULTS: The TLFT originated from the anterior wall of the right CCA and was divided into the superior thyroid artery and linguofacial trunk (LFT). The LFT was divided into lingual and facial arteries. In addition, we observed fusiform dilatation of the intracranial right vertebral artery, which might have caused these symptoms. CONCLUSION: The presence of a common trunk of the external carotid artery (ECA) branches increases the risk of complications such as bleeding and ischemia during treatment of the head and neck region, including chemoradiotherapy for oral bleeding and tongue cancer. Therefore, this is an area of significant interest across various medical specialties, including surgery, otolaryngology, and radiology. Understanding the diverse variations in the neck vasculature is expected to lead to a reduction in complications associated with various procedures.


Asunto(s)
Variación Anatómica , Arteria Carótida Común , Angiografía por Tomografía Computarizada , Humanos , Anciano , Femenino , Arteria Carótida Común/diagnóstico por imagen , Arteria Carótida Común/anomalías , Cuello/irrigación sanguínea
3.
Surg Radiol Anat ; 44(5): 733-736, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35604461

RESUMEN

The right and left vertebral arteries are the first branches of the ipsilateral subclavian arteries. However, in the presence of anatomical variation due to complex embryogenesis, the vertebral artery can arise directly from the aortic arch or any of its major branches. The atypical origin of the vertebral artery is commonly associated with the left vertebral artery. Anatomical variation in the origin of the right vertebral artery is rare. Most available reports are case reports from international studies. We report on a case of right vertebral artery arising from the ipsilateral common carotid artery with an absent brachiocephalic trunk in a South African patient examined by digital subtraction angiography. Reports on anatomical variations are of diagnostic importance prior to surgical interventions or endovascular treatment of cerebrovascular diseases such as cerebral aneurysms and arteriovenous malformations.


Asunto(s)
Tronco Braquiocefálico , Arteria Vertebral , Aorta Torácica/anomalías , Tronco Braquiocefálico/anomalías , Tronco Braquiocefálico/diagnóstico por imagen , Arteria Carótida Común/anomalías , Arteria Carótida Común/diagnóstico por imagen , Humanos , Arteria Subclavia/anomalías , Arteria Vertebral/anomalías , Arteria Vertebral/diagnóstico por imagen
4.
Clin Imaging ; 84: 31-35, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35121503

RESUMEN

INTRODUCTION: Congenital aortic arch anomalies and variants have been extensively characterized in the medical literature. Proper identification of these anomalies is important when surgical or percutaneous interventions are indicated. CASE PRESENTATION: We present a case of a 48-year old male who presented to the emergency department with altered mental status. Magnetic resonance angiography (MRA) findings revealed an aberrant right subclavian artery (ARSA), early bifurcation of the right common carotid artery (CCA) with anomalous origin of the right vertebral artery (VA) from the right common carotid artery bifurcation, anomalous left vertebral artery originating from the aortic arch, and absent left common carotid artery with independent origins of the left external carotid artery (ECA) and internal carotid artery (ICA). No other abnormalities were identified, and the patient demonstrated no symptoms attributable to his vascular anomalies. CONCLUSION: To our knowledge, this unique combination of anomalies has never been reported in the literature. With an understanding of embryological pathways, even exceedingly rare anomalies like this one can be explained.


Asunto(s)
Anomalías Cardiovasculares , Arteria Vertebral , Aorta Torácica , Arterias Carótidas/anomalías , Arterias Carótidas/diagnóstico por imagen , Arteria Carótida Común/anomalías , Arteria Carótida Común/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Arteria Subclavia/anomalías , Arteria Subclavia/diagnóstico por imagen , Arteria Vertebral/anomalías , Arteria Vertebral/diagnóstico por imagen
5.
Acta Medica (Hradec Kralove) ; 64(2): 129-131, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34331434

RESUMEN

In the current study, we display a rare association of an aberrant innervation of the sternocleidomastoid muscle by the ansa cervicalis (AC) with a tortuous common carotid artery (TCCA). In specific, in a male cadaver we observed on the right side of the cervical region, a nerval branch of remarkable size originating from the most distal part of the AC's superior root and after piercing the superior belly of the omohyoid muscle innervated the distal portion of the sternocleidomastoid muscle. Furthermore, we noticed a tortuous course of the initial part of the right common carotid artery. We discuss the surgical significance of the awareness of AC's variations during neurotisation of the recurrent laryngeal nerve in cases of its damage, as well as the importance of aberrant innervation of the sternocleidomastoid muscle by AC for the preservation of muscle's functionality after accessory nerve's damage. Furthermore, we highlight the fact, that the knowledge of the relatively uncommon variant, such as TCCA is crucial for the physician in order to proceed more effectively in differential diagnosis of a palpable mass of the anterior cervical region or deal with symptoms such as dyspnea, dysphagia or symptoms of cerebrovascular insufficiency.


Asunto(s)
Arteria Carótida Común/anomalías , Plexo Cervical/anomalías , Músculos del Cuello/inervación , Cadáver , Humanos , Masculino
6.
J Laryngol Otol ; 135(2): 185-188, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33487184

RESUMEN

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.


Asunto(s)
Lesiones Accidentales/prevención & control , Tronco Braquiocefálico/anomalías , Cuello/cirugía , Tráquea/cirugía , Estenosis Traqueal/cirugía , Lesiones Accidentales/epidemiología , Tronco Braquiocefálico/diagnóstico por imagen , Tronco Braquiocefálico/lesiones , Tronco Braquiocefálico/cirugía , Traumatismos de las Arterias Carótidas/epidemiología , Traumatismos de las Arterias Carótidas/prevención & control , Arteria Carótida Común/anomalías , Arteria Carótida Común/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuello/irrigación sanguínea , Tomografía Computarizada por Rayos X/métodos , Tomografía Computarizada por Rayos X/normas , Estenosis Traqueal/diagnóstico por imagen , Traqueostomía/efectos adversos , Resultado del Tratamiento
8.
Surg Radiol Anat ; 42(10): 1263-1266, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32519040

RESUMEN

Anomalous origins of the vertebral arteries are uncommon and generally associated with other abnormalities of the supra-aortic vessels. We present an extremely rare case where the right vertebral artery is arising from the right common carotid artery, with an absent brachiocephalic trunk, and the right common carotid artery as the first branch of the aortic arch followed by right subclavian artery, without any other abnormalities of the supra-aortic vessels. This vessel variation can affect endovascular procedures, surgical interventions and cause some unexpected clinical symptoms.


Asunto(s)
Variación Anatómica , Arteria Carótida Común/anomalías , Procedimientos Endovasculares/métodos , Aneurisma Intracraneal/cirugía , Arteria Vertebral/anomalías , Angiografía de Substracción Digital , Arteria Carótida Común/diagnóstico por imagen , Procedimientos Endovasculares/instrumentación , Femenino , Cefalea/etiología , Humanos , Aneurisma Intracraneal/complicaciones , Aneurisma Intracraneal/diagnóstico , Angiografía por Resonancia Magnética , Persona de Mediana Edad , Oftalmoplejía/etiología , Arteria Vertebral/diagnóstico por imagen
10.
Surg Radiol Anat ; 42(9): 1081-1083, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32172358

RESUMEN

PURPOSE: Persistent hypoglossal artery (PHA) is the second most common anastomosis between the carotid and vertebrobasilar systems and it demonstrates some variations. METHODS: Using magnetic resonance angiography, we diagnosed a case of low origin of the PHA associated with the high carotid bifurcation, and the resulting origin close to the carotid bifurcation. RESULTS: The PHA is typically clinically silent as in our case, but it could be a potential cause of glossopharyngeal neuralgia, hypoglossal palsy, and intracranial aneurysms or technical complications in interventional procedure such as carotid stenting. CONCLUSIONS: We have described a case of low origin of the PHA associated with high carotid bifurcation. To the best of our knowledge, no similar case has been reported in the English-language literature.


Asunto(s)
Arteria Basilar/anomalías , Arteria Carótida Común/anomalías , Malformaciones Vasculares/diagnóstico , Anciano , Arteria Basilar/diagnóstico por imagen , Arteria Carótida Común/diagnóstico por imagen , Vértebras Cervicales , Humanos , Imagenología Tridimensional , Angiografía por Resonancia Magnética , Masculino , Cuello , Ultrasonografía
12.
Surg Radiol Anat ; 42(4): 411-415, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31531710

RESUMEN

Common carotid artery usually bifurcates at the superior border of thyroid cartilage, corresponding to the C3-4 junction, however bifurcation level may vary. Common carotid bifurcation may have rare variations like separate origins of left internal and external carotid arteries from aortic arch, or bifurcation of common carotid artery within thoracic cavity. Intrathoracic carotid bifurcation is a rare variation with limited number of cases reported. The occurrence of a low carotid bifurcation seems to be embryologically related to the persistence of the ductus caroticus. Additionally, intrathoracic carotid bifurcation can be accompanied by findings of Klippel-Feil syndrome. Herein, we present imaging findings of an incidentally detected intrathoracic left common carotid artery bifurcation in a pediatric patient accompanied by fusion of the cervical vertebrae and ribs.


Asunto(s)
Arteria Carótida Común/anomalías , Vértebras Cervicales/anomalías , Síndrome de Klippel-Feil/diagnóstico por imagen , Costillas/anomalías , Arteria Carótida Común/diagnóstico por imagen , Vértebras Cervicales/diagnóstico por imagen , Niño , Femenino , Humanos , Hallazgos Incidentales , Radiografía Torácica , Costillas/diagnóstico por imagen , Tomografía Computarizada por Rayos X
15.
Ann Vasc Surg ; 64: 410.e7-410.e10, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31639480

RESUMEN

Blunt injuries of the great vessels arising from the aortic arch are usually fatal. The innominate artery lesions represent the most common site of injury after the aortic isthmus distal to the left subclavian artery. Injuries are usually located at the origin of the vessel from the aortic arch, especially in patients with bovine aortic arch. Open traditional repair is a successful but invasive treatment, with long hospital stay and different possible complications. Although a bovine aortic arch presents an increased technical challenge, it is possible to achieve a complete and safe repair of the innominate artery injuries through a total endovascular treatment, with important reduction of risks and complications related to operation, compared to traditional open repair. We report the case of a 62-year-old man in our hospital with a posttraumatic pseudoaneurysm of the innominate artery in the setting of a bovine aortic arch, associated with a transection of the descending thoracic aorta. In the urgent setting, the patient was submitted to a kissing stent of innominate artery-left common carotid artery and deployment of thoracic endoprosthesis to exclude the aortic transection, with good final result.


Asunto(s)
Aneurisma Falso/terapia , Aorta Torácica/lesiones , Tronco Braquiocefálico/lesiones , Arteria Carótida Común/anomalías , Procedimientos Endovasculares/instrumentación , Stents , Lesiones del Sistema Vascular/terapia , Heridas no Penetrantes/terapia , Aneurisma Falso/diagnóstico por imagen , Aorta Torácica/anomalías , Aorta Torácica/diagnóstico por imagen , Tronco Braquiocefálico/anomalías , Tronco Braquiocefálico/diagnóstico por imagen , Arteria Carótida Común/diagnóstico por imagen , Procedimientos Endovasculares/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Resultado del Tratamiento , Lesiones del Sistema Vascular/diagnóstico por imagen , Heridas no Penetrantes/diagnóstico por imagen
16.
Chin J Traumatol ; 23(1): 29-31, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31744657

RESUMEN

Incidence of inadvertent arterial puncture secondary to central venous catheter insertion is not common with an arterial puncture rate of <1%. This is due to the advancements and wide availability of ultrasound to guide its insertion. Formation of arteriovenous fistula after arterial puncture is an unexpected complication. Till date, only five cases (including this case) of acquired arteriovenous fistula formation has been described due to inadvertent common carotid puncture. The present case is a 26-year-old man sustained traumatic brain injuries, chest injuries and multiple bony fractures. During resuscitative phase, attempts at left central venous catheter via left internal jugular vein under ultrasound guidance resulted in inadvertent puncture into the left common carotid artery. Surgical neck exploration revealed that the catheter had punctured through the left internal jugular vein into the common carotid artery with formation of arteriovenous fistula. The catheter was removed successfully and common carotid artery was repaired. Postoperatively, the patient recovered and clinic visits revealed no neurological deficits. From our literature review, the safest method for removal is via endovascular and open surgical removal. The pull/push technique (direct removal with compression) is not recommended due to the high risk for stroke, bleeding and hematoma formation.


Asunto(s)
Fístula Arteriovenosa/etiología , Arteria Carótida Común/anomalías , Cateterismo Venoso Central/efectos adversos , Venas Yugulares/anomalías , Adulto , Humanos , Masculino
17.
Echocardiography ; 36(12): 2227-2233, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31758737

RESUMEN

BACKGROUND: Kinking of the internal carotid artery is a cardiovascular (CV) risk factor. However, it remains unclear as to whether kinking of the common carotid artery (CCA) can also predict CV events. We conducted a long-term follow-up study to examine whether CCA kinking as assessed by carotid ultrasonography is a predictor of CV events in asymptomatic patients with CV risk factors. METHODS: We enrolled 598 patients (mean age, 66.8 ± 11.8 years) who were divided into two groups according to CCA kinking severity: kinking of 0-29° (Group I); and kinking at ≥30° (Group II). We assessed whether CCA kinking predicts CV events during follow-up. RESULTS: A total of 91 CV events were observed during the follow-up period (median, 124 months). Hypertension (P < .0001), prior CV events (P < .0001), CCA kinking (P < .0001), intima-media thickness (P < .0001), and max plaque score (P < .0001) were significantly higher in patients with CV events than those without. The age-adjusted hazard ratio of CCA kinking for CV events was 3.42 (95% CI: 2.2-5.3) in Group II compared to Group I. Cox proportional hazard regression analysis revealed that CCA kinking (HR: 3.02, 95% CI: 1.97-4.67), prior CV events (HR: 2.53 95% CI: 1.604.00), hypertension (HR: 2.19 95% CI: 1.17-4.57), and age (HR: 1.04, 95% CI: 1.02-1.07) were independent predictors of CV events. CONCLUSION: CCA kinking is a powerful independent predictor of CV events in asymptomatic patients with CV risk factors.


Asunto(s)
Enfermedades de las Arterias Carótidas/diagnóstico , Arteria Carótida Común/anomalías , Grosor Intima-Media Carotídeo , Medición de Riesgo/métodos , Anciano , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Arteria Carótida Común/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Japón/epidemiología , Masculino , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo
19.
Neuroradiology ; 61(10): 1165-1172, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31372674

RESUMEN

PURPOSE: To examine the prevalence of the so-called bovine aortic arch variation (common origin of the brachiocephalic trunk and the left common carotid artery) in embolic stroke patients, compared with a control group. METHODS: Aortic arch branching patterns were retrospectively evaluated in 474 individuals with (n = 152) and without (n = 322) acute embolic stroke of the anterior circulation. Contrast-enhanced CT scans of the chest and neck (arterial contrast phase, 1-2-mm slice thickness) were used to evaluate aortic arch anatomy. The stroke cohort included 152 patients who were treated for embolic strokes of the anterior circulation between 2008 and 2018. A total of 322 randomly selected patients who had received thoracic CT angiographies within the same time frame were included as a control group. RESULTS: With a prevalence of 25.7%, the bovine aortic arch variant was significantly more common among patients suffering from embolic strokes, compared with 17.1% of control patients (p = 0.039, OR = 1.67, 95%CI = 1.05-1.97). Stroke patients were more likely to show the bovine arch subtype B (left common carotid artery originating from the brachiocephalic trunk instead of the aortic arch) (10.5% vs. 5.0%, p = 0.039, OR = 2.25, 95%CI = 1.09-4.63), while subtype A (V-shaped common aortic origin of the brachiocephalic trunk and the left carotid) was similarly common in both groups. There was no significant difference regarding the frequency of other commonly observed variant branching patterns of the aortic arch. CONCLUSION: The bovine aortic arch, particularly the bovine arch subtype B, was significantly more common among embolic stroke patients. This might be due to altered hemodynamic properties within the bovine arch.


Asunto(s)
Aorta Torácica/anomalías , Biomarcadores , Tronco Braquiocefálico/anomalías , Arteria Carótida Común/anomalías , Embolia Intracraneal/diagnóstico por imagen , Accidente Cerebrovascular/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Aorta Torácica/diagnóstico por imagen , Tronco Braquiocefálico/diagnóstico por imagen , Arteria Carótida Común/diagnóstico por imagen , Estudios de Cohortes , Angiografía por Tomografía Computarizada , Estudios Transversales , Femenino , Humanos , Aumento de la Imagen , Embolia Intracraneal/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/epidemiología
20.
J Card Surg ; 34(9): 856-857, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31233246

RESUMEN

Anomalies as well as variations of vascular structures are widely diagnosed with today's advanced diagnostic tools and healthcare screening programs. Collateral formation is a well known phenomenon in the presence of stenosis or occlusion to provide blood flow to the distal vasculature. In this report, we present the image of a collateral between the left common carotid artery and right coronary artery in the absence of significant stenosis.


Asunto(s)
Velocidad del Flujo Sanguíneo/fisiología , Arteria Carótida Común/anomalías , Circulación Colateral/fisiología , Circulación Coronaria/fisiología , Vasos Coronarios/diagnóstico por imagen , Malformaciones Vasculares/diagnóstico , Anciano , Arteria Carótida Común/diagnóstico por imagen , Arteria Carótida Común/fisiopatología , Angiografía por Tomografía Computarizada , Angiografía Coronaria , Vasos Coronarios/fisiopatología , Humanos , Masculino , Malformaciones Vasculares/fisiopatología
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