Anatomic Distribution of the Carotid Bulb as Determined by Duplex Ultrasound

2007 ◽  
Vol 31 (2) ◽  
pp. 87-91
Author(s):  
Jenilee B. Thornton ◽  
Ann Marie Kupinski ◽  
Philip S. K. Paty ◽  
R. Clement Darling
Keyword(s):  
Carotid Plaque ◽  
Carotid Arteries ◽  
Duplex Ultrasound ◽  
Carotid Bifurcation ◽  
Ultrasound Images ◽  
Carotid Duplex ◽  
Anatomic Distribution ◽  
Carotid Bulb ◽  
The Common ◽  
Anatomic Region

Ultrasound reports describe carotid plaque as being located within the bulb or bifurcation. These terms are used interchangeably; however they refer to two distinct regions. The purpose of this study was to determine the presence of a bulbous region within the common (CCA), internal (ICA) or external (ECA) carotid arteries by using ultrasound. Ultrasound images were examined from 100 carotid systems from 53 males and 47 females ranging in age from 17–88 years (mean age 65 ± 15 years). An outward dilation, consistent with the expected appearance of a carotid bulb, was observed in the ICA in 49 patients. Nineteen patients had a bulb in both the ECA and ICA. In 10 patients, a bulb was present within both the ICA and CCA. In 5 patients, the CCA, ICA and ECA all contained bulbous regions. A bulb was present only within the CCA in five patients and only within the ECA in three patients. No bulb was present in nine patients. These data reveal that a bulbous region occurs in multiple segments. Defining plaque as being present within the carotid bulb is ambiguous since this applies to more than one vessel. Based on these findings, it is more appropriate to define plaque by using terms such as proximal, mid or distal. Carotid bifurcation refers to a specific anatomic region and would be acceptable as defining the location of disease. However, given carotid bulb variability, the term “carotid bulb” should be removed from common use within carotid duplex interpretations.

Clinical case of a patient with occlusive thrombosis of the right common carotid artery

2021 ◽  
Vol 27 (1) ◽  
pp. 79-86
Author(s):  
Anna S. Zotova ◽  
Tatyana V. Davydova ◽  
Anna M. Snigireva
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Asymptomatic Patient ◽  
Duplex Ultrasound ◽  
Carotid Bifurcation ◽  
Ultrasound Scanning ◽  
Severe Atherosclerosis ◽  
The Common ◽  
The Right ◽  
Color Duplex Ultrasound

The paper presents a case of a patient with floating thrombosis in the right common carotid artery and occlusion of the carotid bifurcation of the right common carotid artery against the background of severe atherosclerosis of the common carotid artery with 70% stenosis. Thrombosis was identified using color duplex ultrasound scanning in an asymptomatic patient. During hospitalization, thrombosis was complicated by a cerebral infarction of the right middle cerebral artery, apparently of embolic origin.

Diagnosis and Treatment of Carotid Body Tumors

1978 ◽  
Vol 87 (5) ◽  
pp. 614-621 ◽  
Author(s):  
Paul H. Ward ◽  
Herman A. Jenkins ◽  
William N. Hanafee
Keyword(s):  
Carotid Body ◽  
Arterial Wall ◽  
Carotid Arteries ◽  
External Carotid ◽  
Graft Replacement ◽  
Arterial Anastomosis ◽  
Feeding Vessels ◽  
Carotid Body Tumors ◽  
Carotid Bulb ◽  
The Common

The diagnosis and management of carotid body tumors are discussed, including the importance of good arteriography which allows visualization of all major feeding vessels. These include the carotid bulb, internal and external carotid arteries and the often neglected but important vertebral and ascending cervical arteries. Emphasis is placed on the importance of establishing tourniquet control of the common, internal and external carotid arteries. Surgeons removing carotid body tumors should be experienced in arterial wall repair by means of vascular shunts, end-to-end arterial anastomosis, and vein graft replacement of a segment of arterial wall.

scholarly journals Variations, relations and clinical significance of carotid arterial system in anterior neck: a cadaveric study

2019 ◽  
Vol 7 (4) ◽  
pp. 1127
Author(s):  
Anasuya Ghosh ◽  
Subhramoy Chaudhury ◽  
Atin Datta
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Hypoglossal Nerve ◽  
Carotid Bifurcation ◽  
External Carotid Artery ◽  
Arterial System ◽  
External Carotid ◽  
The Common ◽  
Carotid Arterial

Background: The common carotid, internal and external carotid arteries and their branches serve as major source of blood supply in head-neck region of human and are often encountered during numerous surgical and clinical interventions of neck.Methods: We dissected and examined both sides of neck in 49 well embalmed cadavers (98 sides). We recorded the following anatomical parameters of carotid arterial system-level of bifurcation, the relation between internal and external carotid arteries, branching pattern of anterior branches of external carotid artery, tortuosity in carotid arterial system, and relation of hypoglossal nerve with the carotid arteries.Results: In 56.16 % cases, the common carotid arterial bifurcation took place at the upper border of thyroid cartilage though high bifurcation was quite common (43.88%). The external carotid artery was located antero-medial to internal carotid artery in most cases (93.87%). Abnormal tortuosity of carotid arterial system was detected in 2.04% cases only. In 86.73% cases, the hypoglossal nerve crossed the internal and external carotid artery superior to carotid bifurcation above the level of hyoid bone while in 1 case it crossed immediately inferior to carotid bifurcation. In branching pattern, following variations were observed- linguo-facial trunk in 15.3% cases, thyro-lingual trunk in 5.1% cases, origin of superior thyroid artery from common carotid in 10.02% cases and origin of superior thyroid from internal carotid in one case (1.02%).Conclusions: The carotid arterial system has complex and variable anatomy in neck and this information should be kept in mind to avoid unwanted damage during surgical procedures of neck.

Asymmetrical distribution of atherosclerosis in the carotid artery: identical patterns across age, race, and gender

2011 ◽  
Vol 19 (4) ◽  
pp. 687-697 ◽  
Author(s):  
Parvin Tajik ◽  
Rudy Meijer ◽  
Raphaël Duivenvoorden ◽  
Sanne AE Peters ◽  
John J Kastelein ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Carotid Atherosclerosis ◽  
Internal Carotid ◽  
Intima Media Thickness ◽  
Carotid Bifurcation ◽  
Carotid Intima Media Thickness ◽  
Future Design ◽  
The Common ◽  
The Individual

Background: Small autopsy studies and clinical practice indicated that carotid atherosclerosis develops in an asymmetrical helical pattern coinciding with regions of low shear stress. We investigated the distribution of carotid atherosclerosis as determined by maximum carotid intima-⊟media thickness (CIMT), to assess if we could confirm this atherosclerotic configuration across various populations with different cardiovascular risk. Methods and results: We used the individual baseline CIMT data from 3364 subjects from four recent international multicentre randomized controlled trials in which the carotid artery was systematically examined using the same ultrasound protocol and method to quantify CIMT. For each subject, circumferential information on the maximum CIMT of the left and right carotid arteries was obtained for the common carotid, bifurcation, and internal carotid artery segments. In each segment (common, bifurcation, internal), mixed modelling was used to study the differences in CIMT between angles, sides, gender, age, race, and studies. Each segment showed a different circumferential CIMT pattern. In all segments there were statistically significant differences between maximum CIMT across circumferential angles ( p < 0.001); on average CIMT was highest in the posteromedial wall of the bifurcation and internal carotid segments and in the anterolateral wall of the common carotid segment. This asymmetric circumferential pattern was found to be identical in men and women, in young and old age, in different race groups, and across the studies. Conclusions: We confirmed the asymmetrical helix-like distribution of atherosclerosis in the carotid arteries and expand the evidence by showing that the atherosclerotic configuration is similar across populations with different vascular risks and across gender, age, and race. This has implications for future design of carotid ultrasound studies, as the angle of insonation is an important predictor of maximum CIMT.

scholarly journals Morphological characteristics of the external carotid artery

2013 ◽  
Vol 19 (2) ◽  
pp. 74-78
Author(s):  
P. Gavrilidou ◽  
D.M. Iliescu ◽  
R. Baz ◽  
P. Bordei
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Morphological Characteristics ◽  
Carotid Bifurcation ◽  
External Carotid Artery ◽  
External Carotid ◽  
The Common ◽  
The One ◽  
The Right

Abstract The morphological characteristics at the level of the bifurcation of the common carotid artery were studied on 46 cases, finding that the most frequent, in 52.17% of cases, the common carotid bifurcation appear as the letter “V”, with two possible variations: a wide “V”, in 43.48% of cases and narrow “V” in 8.7% of cases. In 30.43% of cases, the two carotids showed an ascending traject, united for 1-2 cm up to their crossing; in 13,04% of the cases the two arteries were superimposed, the external located anteriorly. In only in two cases on the right side (4.35% of cases and 8.33% of right samples) we found a peculiar aspect of a “U” shaped bifurcation. Regarding the caliber of the external carotid artery, we found that in 43.33% of the cases the external carotid artery had a similar diameter to the internal carotid, also in 43.33% of the external carotid artery have a higher caliber than internal one and the remaining 13.33% of the cases, the external carotid artery had a smaller diameter than the internal one, with all cases on the left (16.67% of left carotid arteries). The caliber of the right external carotid artery was between 4 to 5.6 mm and the one of the left was between 3.6 to 5 mm. When the external carotid was more voluminous than the internal, the differences were 0.5 to 1.2 mm and when the internal carotid was more voluminous than the external, the differences were smaller, 0.2 to 0.8 mm. In relation to the common carotid, the external carotid had a smaller caliber from 0.6 to 1.1 mm. Regarding the external carotid traject, most commonly, from the bifurcation of the common carotid, the external carotid artery showed a vertical trajectory, in 50% of cases; in 40% of cases, the traject was oblique superomedially and in 6.67% of cases the external carotid artery described a curve with the convexity facing laterally, with all cases on the right (11.76% of right carotid arteries); in 3.33% of cases, both on the left (7.69% of the left carotid arteries), the external carotid artery traject described an inverted italic “S”

Occlusion of the Extracranial Carotid Arteries

2017 ◽  
Vol 41 (3) ◽  
pp. 118-122
Author(s):  
Adam E. Jackson
Keyword(s):  
Cerebrovascular Accident ◽  
Carotid Arteries ◽  
Treatment Options ◽  
Duplex Ultrasound ◽  
Carotid Occlusion ◽  
Carotid Disease ◽  
True Incidence ◽  
Carotid Duplex ◽  
Atherosclerotic Process

Carotid duplex ultrasound (CDU) is a commonly performed vascular exam for the detection of carotid disease. In most cases, the exam is performed to detect hemodynamically significant changes that could cause a cerebrovascular accident. Ultrasound is accurate in the detection of >70% stenosis. CDU exams are often used to detect a potentially harmful atherosclerotic process before it embolizes. In some cases, the atherosclerotic formation will be so great that it will occlude the extracranial vessels. The true incidence of carotid occlusion is not well known as it may be asymptomatic. CDU can show where the occlusion is located and if the bifurcation is patent which can reveal treatment options for the patient. Carotid occlusions can be medically managed or may require surgery to restore flow to the cerebrovasculature.

scholarly journals An integrated system for the complete segmentation of the common carotid artery bifurcation in ultrasound images

2015 ◽  
Vol 1 (1) ◽  
pp. 11 ◽  
Author(s):  
Christos P. Loizou ◽  
Marios Pantziaris
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Carotid Plaque ◽  
Research Work ◽  
Texture Features ◽  
Intima Media Thickness ◽  
Risk Groups ◽  
Integrated System ◽  
Ultrasound Images ◽  
The Common

The complete segmentation of the common carotid artery (CCA) bifurcation in ultrasound images is important for the evaluation of atherosclerosis disease and the quantification of the risk of stroke. The current research work further evaluates and validates a semi-automated (SA) snake’s based segmentation system suitable for the complete segmentation of the CCA bifurcation in two-dimensional (2D) ultrasound images. The proposed system semi-automatically estimates the intima-media thickness (IMT), the atherosclerotic carotid plaque borders and dimensions, the internal carotid artery (ICA) origin’s stenosis, the carotid diameter (D), as well as other geometric measurements of the atherosclerotic carotid plaque.  The system was evaluated on 300 2D longitudinal ultrasound images of the CCA bifurcation with manual (M) segmentations available from a neurovascular expert. No statistical significant differences between all M and SA IMT, plaque and D segmentation measurements were found. In a future study, texture features extracted from the intima-media complex (IMC) may be used to separate subjects in high and low risk groups, which may develop a stroke. However, a larger scale study is required for evaluating the system before its application in the real clinical practice.

Tandem High-grade Stenoses in the Innominate and Right Internal Carotid Arteries Diagnosed with Carotid Duplex Ultrasound

2008 ◽  
Vol 32 (4) ◽  
pp. 200-204
Author(s):  
Susan M. Whitelaw ◽  
Alia Grattan ◽  
Christopher Bajzer ◽  
Heather L. Gornik
Keyword(s):  
Carotid Arteries ◽  
Internal Carotid ◽  
Duplex Ultrasound ◽  
High Grade ◽  
Carotid Duplex ◽  
Internal Carotid Arteries

Anatomic Distribution of the Carotid Bulb as Determined by Duplex Ultrasound

2015 ◽  
Vol 39 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Jenilee B. Thornton ◽  
Ann Marie Kupinski ◽  
Philip S. K. Paty ◽  
R. Clement Darling
Keyword(s):  
Duplex Ultrasound ◽  
Anatomic Distribution ◽  
Carotid Bulb

scholarly journals The carotid axis revisited

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
R. Cobiella ◽  
S. Quinones ◽  
M. Konschake ◽  
P. Aragones ◽  
X. León ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Pearson Correlation ◽  
Carotid Bifurcation ◽  
The Body ◽  
External Carotid ◽  
Average Height ◽  
The Common ◽  
The Right

AbstractThe aim was to determine the variations in the level of origin of carotid bifurcation and diameters of the common, internal, and external carotid arteries which is clinically important for several interventional procedures. Therefore, 165 human embalmed corpses were dissected. The data collected were analyzed using the Chi square-test and the Pearson correlation test. The results of previous studies have been reviewed. In relation to the level of the carotid bifurcation, taking as a reference point the hyoid bone, the values ranged from 4 cm below the hyoid body to 2.5 cm above the body of the hyoid, being the average height—0.33 cm, with a standard deviation of 1.19 cm. The right carotid bifurcation was established at a higher level (x = − 0.19 cm.) than the left one (x = − 0.48 cm.) (p = 0.046). On the contrary, no significant gender differences could be observed. The arterial calibres of the common and internal carotid arteries were higher in male than female. In the internal carotid artery (X = 0.76 cm.), the left was greater than the right (X = 0.72 cm.) (P = 0.047). However, no differences in the distribution of the calibre of the external carotid artery were found neither by side nor gender. Variations in the level of bifurcation and calibres of carotid arteries are relevant for interventional radiology procedures and head and neck surgeries. Knowledge of these anatomical references might help clinicians in the interpretation of the carotid system.

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