Image and clinical analysis of common carotid web: a case report

Abstract Background A carotid web is a very rare vascular disease of the carotid artery, leading to thrombosis and ischemic stroke. Case presentation A 65-year-old male patient was admitted due to left limb weakness. On arrival, he had moderate left hemiplegia, neglect, and sensory loss; the National Institutes of Health Stroke Scale score was 8. Computed tomography angiography (CTA) and magnetic resonance (MR) examination were performed to determine the cause of basal ganglia infarction. Thin-section axial CTA showed a membrane-like structure in the posterior wall of the right common carotid artery. The sagittal reconstruction image showed a membrane-like protrusion in the posterior wall of the right common carotid artery under the right carotid sinus. The MR axial T2 image showed a membrane-like high-signal protrusion into the carotid artery lumen, which was diagnosed as a right carotid web. The patient was treated with dual antihypertensive therapy by adjusting blood pressure, controlling brain edema, improving cerebral circulation, and nourishing the nerves. Conclusion Careful comparison of axial thin-layer CTA and MR axial T2 images combined with sagittal reconstruction of CTA images can greatly improve the diagnostic rate of carotid web.

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Two cases of symptomatic common carotid artery occlusion treated by carotid endarterectomy with L-shaped ministernotomy

Surgical Neurology International ◽

10.25259/sni_463_2019 ◽

2020 ◽

Vol 11 ◽

pp. 1

Author(s):

Shotaro Ogawa ◽

Fukutaro Ohgaki ◽

Ryosuke Mizuta ◽

Yasuyuki Furuta ◽

Shigeta Fujitani ◽

...

Keyword(s):

Carotid Artery ◽

Carotid Endarterectomy ◽

Cerebral Artery ◽

Common Carotid Artery ◽

Artery Occlusion ◽

Carotid Artery Occlusion ◽

Partial Sternotomy ◽

Left Limb ◽

The Right ◽

Common Carotid Artery Occlusion

Background: Common carotid artery occlusion (CCAO) is rare. Symptomatic lesions are resistant to medical treatment and revascularization are often required, but there is no consensus on the treatment of CCAO. In this paper, two cases of symptomatic CCAO treated by carotid endarterectomy (CEA) with L-shaped ministernotomy, in which the lesions extended to the beginning part of the CCA, are reported. Case Description: Case 1 involved a 74-year-old man who presented with transient left limb numbness and an abnormal right visual field. Cerebrovascular angiography showed that the right CCA was occluded immediately after its origin and blood was supplied from the posterior circulation. CEA was performed with an L-shaped ministernotomy that allowed exposure of the CCA origin with minimal invasion. There were no complications associated with the sternal incision and he was discharged with a modified Rankin Scale (mRS) score of 0. Case 2 involved a 70-year-old man who presented with left half-blindness. Magnetic resonance imaging showed infarction in the right posterior cerebral artery region and neck echo showed CCA pseudo occlusion just before the carotid bulb. A new infarction in the right middle cerebral artery region developed during hospitalization. CEA with partial sternotomy was performed. The patient was rehabilitated with no deterioration of neurological findings and transferred with an mRS score of 3. Conclusion: There were no complications resulting from partial sternotomy in the two cases presented. CEA with partial sternotomy could be an effective treatment option for CCAO in which the internal carotid artery is patent and thrombus extends to the proximal CCA.

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Synchronous Carotid Bifurcation Endarterectomy and Retrograde Kissing Stenting of the Innominate and Left Common Carotid Artery in a Patient with a Bovine Aortic Arch

Case Reports in Surgery ◽

10.1155/2017/4239829 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Alessandro Robaldo ◽

Guido Carignano ◽

Alberto Balderi ◽

Claudio Novali

Keyword(s):

Carotid Artery ◽

Aortic Arch ◽

Common Carotid Artery ◽

Carotid Arteries ◽

High Risk Patient ◽

Carotid Bifurcation ◽

Left Common Carotid Artery ◽

The Right ◽

Bovine Aortic Arch ◽

Common Carotid Arteries

Management of the symptomatic multiple stenosis of supra-aortic vessels (MSSVs) in a “bovine” aortic arch (BAA) configuration is infrequently reported. The optimal treatment choice remains debatable. A successful hybrid treatment for a proximal critical stenosis of the innominate and left common carotid artery was performed in a high-risk patient with a tandem symptomatic lesion in the right carotid bifurcation and a concentric vulnerable plaque in the bovine trunk. This case supports the feasibility, safety, and efficacy of a combined carotid bifurcation endarterectomy and retrograde kissing stenting of common carotid arteries with cerebral protection after evaluation of radiological, anatomical, and clinical parameters.

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Cervical artery dissection—an easily neglected cause of stroke: a case report

BMC Neurology ◽

10.1186/s12883-020-02006-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Ya -Hui Lian ◽

Xin Chen ◽

De- Rui Kong ◽

Wei Chen ◽

Ming-Chao Shi ◽

...

Keyword(s):

Young People ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Vascular Occlusion ◽

Artery Dissection ◽

High Signal ◽

Cervical Artery Dissection ◽

Cervical Artery ◽

The Right

Abstract Background In recent years, the incidence of stroke has gradually increased in young people. There are many reasons causing stroke, including atherosclerosis, artery embolization, and cervical artery dissection and so on. However, cervical artery dissection is a major cause of stroke in young people. We present a case of ischemic stroke caused by dissection, whose distal vascular occlusion due to detachment of the thrombosis in the right internal carotid artery. Case presentation A 33-year-old male patient was admitted to the hospital because of stroke. Imaging examination showed that there was no visualization of the right middle cerebral artery and there were a large number of mural thrombus in the C1 segment of the right internal carotid artery. After emergency surgery, the patient had vascular recanalization and the symptoms were significantly improved. Magnetic resonance imaging showed a high signal in the C1 segment of the right internal carotid artery, the abnormal signal disappeared after antiplatelet therapy. Conclusions When a patient has symptoms of stroke, we need to explore the root cause of stroke. Especially in young people, cervical artery dissection is an important reason that can’t be ignored. Through review and analysis of this case, we hope to improve the understanding of radiologists and clinicians about the cervical artery dissection, reduce the rate of misdiagnosis, and improve patients’ prognosis.

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Intrathoracic bifurcation of the right common carotid artery

BMJ Case Reports ◽

10.1136/bcr-2012-007554 ◽

2013 ◽

Vol 2013 (jan09 1) ◽

pp. bcr2012007554-bcr2012007554 ◽

Cited By ~ 6

Author(s):

C. K. Gomez ◽

O. J. Arnuk

Keyword(s):

Carotid Artery ◽

Common Carotid Artery ◽

The Right

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

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2021-3-94-99 ◽

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

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.Received 26 March 2021. Revised 6 May 2021. Accepted 11 May 2021.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflicts of interests.Contribution of the authors: The authors contributed equally to this article.

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Free-floating thrombus in the right common carotid artery

Journal of Cardiology ◽

10.1016/j.jjcc.2008.11.013 ◽

2009 ◽

Vol 54 (2) ◽

pp. 304-306 ◽

Cited By ~ 1

Author(s):

Eiji Taguchi ◽

Kazuhiro Nishigami ◽

Takihiro Kamio ◽

Takashi Honda ◽

Koichi Nakao

Keyword(s):

Carotid Artery ◽

Common Carotid Artery ◽

Floating Thrombus ◽

The Right

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An unusual origin of the right subclavian artery – arteria lusoria

Current Issues in Pharmacy and Medical Sciences ◽

10.1515/cipms-2015-0022 ◽

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.

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

Medical Journal of the Russian Federation ◽

10.17816/0869-2106-2021-27-1-79-86 ◽

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.

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P186 CAROTID-GASTROPLASTY FISTULA: AN UNCOMMON CAUSE OF HEMATEMESIS IN THE DELAYED POSTOPERATIVE PERIOD AFTER ESOPHAGECTOMY

Diseases of the Esophagus ◽

10.1093/dote/doz092.186 ◽

2019 ◽

Vol 32 (Supplement_2) ◽

Author(s):

L Hurtado-Pardo ◽

Navarro F Mingol ◽

Jiménez de Zadava Lissón M Menéndez ◽

Alonso C Pérez ◽

Esteban M Bruna ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Carotid Artery ◽

Cell Carcinoma ◽

Surgical Approach ◽

Postoperative Period ◽

Common Carotid Artery ◽

Muscle Flap ◽

Floor Of The Mouth ◽

Massive Hematemesis ◽

The Right

Abstract Aim To describe a case report of a carotid-gastroplasty fistula post esophagectomy with a successful result. Background & Methods Upper gastrointestinal bleeding due to a fistula between esophagus or gastroplasty and carotid vessels is infrequent. It is usually due to malignant tumors, penetrating trauma, foreign bodies or radiotherapy. Results A 55-year-old man, with background of laryngeal squamous cell carcinoma that was treated with total laryngectomy and tracheostomy followed by radiotherapy, and posterior recurrence of squamous cell carcinoma at the upper esophagus required total esophagectomy with pharynguectomy and lymphadenectomy, and reconstruction with gastroplasty with anastomosis to the floor of the mouth and pectoralis muscle flap. During this second postoperative period, patient developed a left hemiplegia secondary to thrombosis of the right common carotid artery. After recovery, the patient had repeated episodes of hematemesis that required hospital admission and blood transfusion. After several episodes with conservative management, upper endoscopy revealed blood oozing close to the anastomosis with no other findings. Once again, the patient returned to the emergency department with massive hematemesis, being visualized by endoscopy a high-flow arterial bleeding close to the anastomosis of the floor of the mouth. Arteriography showed the already known thrombosis of the right common carotid artery and the origin of the bleeding distal to that occlusion, where it was repermeabilized by a branch of the right vertebral artery. Given the inability of selective embolization by interventional radiology, urgent surgical approach was decided, performing a right lateral cervicotomy and identifying a fistula that communicated the common carotid artery with gastroplasty. It proceeded to close the fistulous orifice of the arteria and the gastroplasty with a continuous suture. A partial sternocleidomastoid muscle flap was interposed between the two sutures. The postoperative evolution was satisfactory. Patient was discharged 16 days after surgery and being currently stable without signs of hemorrhagic neither oncological recurrence. Conclusion Carotid-gastroplasty fistula is a rare complication with high mortality rate due to its more frequent presentation: the massive hematemesis. Gastrointestinal endoscopy and angiography allow us to diagnose and treat this complication, however in massive and uncontrollable bleeding, surgical approach is indicated. Prognosis will depend on the early diagnosis and a therapeutic individualization is required.

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Variations in the anatomical relationship between the common carotid artery and the internal jugular vein: An ultrasonographic study

Colombia Medica ◽

10.25100/cm.v46i2.1652 ◽

2015 ◽

pp. 54-59 ◽

Cited By ~ 3

Author(s):

Mauricio Umaña Perea ◽

Alberto Federico García ◽

José Luis Castillo García ◽

Luis Alfonso Bustamante Cristancho ◽

Juan Sebastián Martínez Collazos

Keyword(s):

Multivariate Analysis ◽

Carotid Artery ◽

Internal Jugular Vein ◽

Common Carotid Artery ◽

Jugular Vein ◽

Patients Âgés ◽

Anterior Position ◽

Anatomical Relationship ◽

The Common ◽

The Right

Introduction: The internal jugular vein locates anterior or anterolateral to the common carotid artery in two-thirds of the subjects studied by ultrasound when the head is in a rotated position. Aim: To identify variables associated with the anterior location of the internal jugular vein. Methods: Ultrasound examinations were performed with the patients in the supine position, with the head rotated to the opposite side. The proximal third of the neck was visualized transversely with a 7.5-mHz transducer. The relationship between the vessels was described in accordance with the proportion of the artery overlapped by the vein. Univariate comparisons and a multivariate analysis of potential variables that may affect the anatomic relationships were performed. Results: Seventy-eight patients were included, 44 of whom were men. The patients' ages ranged from 17 to 90 years (median 64.0, interquartile range 41-73). The right and left sides were studied 75 and 73 times, respectively. The vein was located lateral to the artery in 24.3% (95%CI= 17.4-32.2) of the studies, anterolateral in 33.8% (95%CI= 26.2-41.4) and anterior in 41.9% (95%CI= 33.9-49.8). The multivariate analysis identified age group (OR= 3.7, 95% CI 2.1-6.4) and, less significantly, the left side (OR= 1.7, 95%CI= 0.8-3.5) and male gender (OR= 1.2, 95%CI= 0.6-2.7) as variables associated with the anterior position of the vein. Conclusión: The anterior position of the internal jugular vein relative to the common carotid artery increases gradually with age. Additionally, left-sided localization and male sex further increased the probability of an anterior position.

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