scholarly journals A cadaveric study of relationship of external carotid artery with reference to adjacent anatomical landmarks

2021 ◽  
Vol 8 (4) ◽  
pp. 255-259
Author(s):  
Anjalee G Ovhal ◽  
K Ravikumar ◽  
Sachin Badge
Keyword(s):  
Carotid Artery ◽  
Carotid Bifurcation ◽  
External Carotid Artery ◽  
External Carotid ◽  
Anatomical Landmarks ◽  
Therapeutic Procedures ◽  
The Right ◽  
Radiological Procedures ◽  
Relationship Of ◽  
The Relationship

Evaluation of carotid bifurcation level and relationship of External Carotid Artery (ECA) with reference to adjacent anatomical landmarks is important in planning various surgical and radiological procedures related to the carotid arteries. The aim was to study the relationship of External Carotid Artery with reference to Adjacent Anatomical landmarks in cadavers. 60 cadavers - 52 male and 8 female embalmed with 10% formalin were dissected over the period of two years for this study. The distance between the origin and the termination of ECA was found to be in the range of 25–70 mm on the right side and in the range of 25–68 mm on the left side. The distance between the origin of ECA and the carotid tubercle was found to be in the range of 23–50 mm on the right side and in the range of 22–48 mm on the left side. The distance between the origin of ECA and the angle of the mandible was found to be in the range of 18–30 mm on the right side and in the range of 20–32 mm on the left side. The anatomical knowledge of relationship of External Carotid Artery with reference to adjacent anatomical landmarks is helpful for vascular surgeons to plan surgeries and prevent complications during various diagnostic and therapeutic procedures.

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”

scholarly journals Variations in the Branching Pattern of External Carotid Artery in South Kerala Population – A Cadaveric Study

2021 ◽  
Vol 8 (22) ◽  
pp. 1780-1785
Author(s):  
Manju Sudhakaran ◽  
Mini Alikunju ◽  
Vandana Latha Raveendran ◽  
Umesan Kannanvilakom Govindapillai
Keyword(s):  
Carotid Artery ◽  
Head And Neck ◽  
Carotid Arteries ◽  
Carotid Bifurcation ◽  
External Carotid Artery ◽  
External Carotid ◽  
Superior Thyroid Artery ◽  
South Indian Population ◽  
Branching Pattern ◽  
South Indian

BACKGROUND External carotid arteries account for a major share of arterial supply of head and neck regions. As variations are frequently observed in the branching pattern of external carotid artery, surgeons, radiologists and anaesthetists often encounter difficulties in various procedures of head and neck. The purpose of this study is to describe the variations in the branching pattern of external carotid artery as observed in South Indian population which definitely reduces its iatrogenic injuries associated with surgical and radiological procedures of head and neck. METHODS This is cross-sectional descriptive study. Bilateral neck dissection was done on twenty-two formalin fixed cadavers to study the branching pattern of external carotid artery during a period of two years in the Department of Anatomy in Government Medical College, Alappuzha. Common carotid, external carotid and internal carotid arteries were dissected. All the branches of external carotid artery were traced and the variations were noted. The distance between carotid bifurcation and point of origin of individual branches of external carotid were measured and statistically analyzed. RESULTS In the present study along with normal branching pattern of external carotid artery, variations like origin of superior thyroid artery from common carotid artery and also from carotid bifurcation were seen. A common linguofacial trunk and direct origin of superior laryngeal artery from external carotid artery were also observed. CONCLUSIONS Prior knowledge of the variations will be helpful to surgeons and anaesthetists while dealing with these vessels during procedures of head and neck regions. KEYWORDS External Carotid Artery, Carotid Bifurcation, Superior Thyroid Artery, Linguofacial Trunk

scholarly journals Intravascular Endothelin-1 does not trigger or increase susceptibility to Spreading Depolarizations

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kazutaka Sugimoto ◽  
Andreia Morais ◽  
Homa Sadeghian ◽  
Tao Qin ◽  
David Y. Chung ◽  
...  
Keyword(s):  
Acetic Acid ◽  
Carotid Artery ◽  
Carotid Bifurcation ◽  
External Carotid Artery ◽  
External Carotid ◽  
Sprague Dawley ◽  
Vascular Events ◽  
Endothelin 1 ◽  
Pathological Conditions ◽  
Potent Vasoconstrictor

Abstract Objectives Spreading depolarizations (SD) likely manifest as aura in migraineurs. Triggers are unknown although vascular events have been implicated. Direct carotid puncture has been reported to trigger migraine with aura. The potent vasoconstrictor endothelin-1 (ET-1), which can be released from the endothelium under pathological conditions, may play a role. Here, we tested whether intracarotid ET-1 infusion triggers SD and whether systemic ET-1 infusion increases the susceptibility to SD. Methods Carotid infusions were performed in mice (C57BL/6, male) through a catheter placed at the carotid bifurcation via the external carotid artery. Intracarotid ET-1 (1.25 nmol/ml) was infused at various rates (2–16 μl/min) with or without heparin in the catheter and compared with vehicle infusion (PBS with 0.01% acetic acid) or sham-operated mice (n = 5). Systemic infusions ET-1 (1 nmol/kg, n = 7) or vehicle (n = 7) infusions were performed in rats (Sprague-Dawley, male) via the tail vein. Electrical SD threshold and KCl-induced SD frequency were measured after the infusion. Results Intracarotid infusion of saline (n = 19), vehicle (n = 7) or ET-1 (n = 12) all triggered SDs at various proportions (21%, 14% and 50%, respectively). These were often associated with severe hypoperfusion prior to SD onset. Heparinizing the infusion catheter completely prevented SD occurrence during the infusions (n = 8), implicating microembolization from carotid thrombi as the trigger. Sham-operated mice never developed SD. Systemic infusion of ET-1 did not affect the electrical SD threshold or KCl-induced SD frequency. Conclusion Intravascular ET-1 does not trigger or increase susceptibility to SD. Microembolization was the likely trigger for migraine auras in patients during carotid puncture.

In Vitro Comparison of Four Cerebral Protection Filters for Preventing Human Plaque Embolization during Carotid Interventions

2002 ◽  
Vol 9 (6) ◽  
pp. 793-802 ◽  
Author(s):  
Stefan Müller-Hülsbeck ◽  
Thomas Jahnke ◽  
Carsten Liess ◽  
Christoph Glass ◽  
Friedrich Paulsen ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Bifurcation ◽  
External Carotid Artery ◽  
Cerebral Protection ◽  
External Carotid ◽  
Carotid Angioplasty ◽  
Protection Device ◽  
Fluid Medium ◽  
Vitro Model

Purpose: To evaluate in an in vitro bench-top model the efficacy of 4 filtration devices designed for cerebral protection during carotid angioplasty. Methods: Embolization during carotid angioplasty was simulated with human plaque material (8 to 12 particles weighing 6.02 ± 0.10 mg) in an open flow model with the aortic arch and carotid bifurcation made from elastic silicone tubes and saline used as the fluid medium. The 500 to 1500-µm particles were injected into the internal carotid artery (ICA) in front of the test protection device, which was deployed 5 cm distal to the bifurcation. Particles getting past the protection device or flowing into the external carotid artery (ECA) were caught in 100-µm filters and weighed. Ten trials were made on each of 4 devices: Angioguard, FilterWire EX, TRAP, and NeuroShield. All were deployed according to the manufacturers' directions except the FilterWire, which was manually repositioned in all tests to eliminate a gap between the filter and the tube wall. Results: The lowest weight of missed particles in the effluent was obtained with the NeuroShield (0.05 ± 0.04 mg, 0.8% of injected particle weight) and FilterWire (0.08 ± 0.05 mg, 1.3%; p=0.254 compared to NeuroShield, p=0.006 versus TRAP). The weight of particles missed by the TRAP device (0.16 ± 0.06 mg, 2.6%; p<0.001 versus NeuroShield and Angioguard, p<0.05 compared to Filter Wire) was higher, and the largest amount of missed particles was observed with the Angioguard filter (0.27 ± 0.06 mg, 4.4%; p<0.001 compared to all). NeuroShield and FilterWire were significantly different (p<0.001) compared to Angioguard and TRAP in a pairwise analysis. No embolization into the ECA occurred. Conclusions: In vitro, none of the tested devices had the ability to completely prevent embolization into the ICA. Comparing current designs, the NeuroShield filter and the FilterWire EX captured the highest percentage of human particles in this in vitro model, probably due to their larger filter volume.

Direct carotid sinus approach to treatment of bilateral carotid-cavernous fistulas

1988 ◽  
Vol 69 (6) ◽  
pp. 942-944 ◽  
Author(s):  
Pedro Albert ◽  
Manuel Polaina ◽  
Francisco Trujillo ◽  
José Romero
Keyword(s):  
Carotid Artery ◽  
External Carotid Artery ◽  
External Carotid ◽  
Occipital Artery ◽  
Lateral Sinus ◽  
Direct Puncture ◽  
Content Type ◽  
Bilateral Carotid ◽  
The Right ◽  
Carotid Cavernous Fistulas

✓ The authors present a patient with a complex vascular malformation composed of bilateral spontaneous carotid-cavernous fistulas (CCF's). The abnormality was supplied on the right side by the right external carotid artery (ECA) and the right internal carotid artery (ICA), and on the left side only by the left ICA. There was also an arteriovenous communication between the right ECA and the lateral sinus. Surgical embolization of both cavernous sinuses with oxidized cellulose was achieved on one side by direct puncture and on the other through one of its venous affluents, successfully occluding both CCF's and preserving the patency of both ICA's without any neurological deficit. The arteriovenous communication between the right ECA and the lateral sinus was occluded by embolization of the occipital artery and ligation of the right ECA.

Cervical paragangliomas: diagnosis, management and complications

2001 ◽  
Vol 115 (6) ◽  
pp. 467-474 ◽  
Author(s):  
M. Hossam Thabet ◽  
Hesham Kotob
Keyword(s):  
Carotid Artery ◽  
Superior Laryngeal Nerve ◽  
Carotid Bifurcation ◽  
Styloid Process ◽  
External Carotid Artery ◽  
External Carotid ◽  
Digastric Muscle ◽  
Vascular Injuries ◽  
Nerve Paralysis ◽  
Transcervical Approach

Sixteen patients were diagnosed as suffering from cervical paragangliomas. Eleven patients (68.75 per cent) had twelve carotid paragangliomas (CPs), and five patients (31.25 per cent) had six vagal paragangliomas (VP). One CP (8.33 per cent) originated from paraganglia around the common carotid artery (CCA). Three cases of multiple paragangliomas are presented (18.75 per cent). In 80 per cent (4/5) of VP patients there was widening of the carotid bifurcation similar to that seen with CP. This widening occurred whenever the VP was large enough to grown in between the external carotid artery and internal carotid artery (ECA and ICA). Large VPs may displace the vessels either anterolaterally or anteromedially. Knowledge of the direction of the carotid displacement is essential to avoid intra-operative vascular injuries. Colour flow doppler ultrasound (CFD-US) was found to be a good non-invasive method for diagnosis of vascular neck swellings. It enabled the diagnosis of CP with 100 per cent accuracy, but it was not sufficient for diagnosis of high VP. A transcervical approach, cutting the digastric muscle and the styloid process with the attached ligaments and muscles, was sufficient for excision of most VP. However, midline mandibulotomy might be necessary with high VP. Vascular injuries occurred in 12.5 per cent (2/16) of patients. Superior laryngeal nerve and hypoglossal nerve paralysis occurred, respectively, in (2/11) and (1/11) of patients with CP. Vagal paralysis occurred in all patients with VP. Cerebrovascular accident and post-operative death occurred in one patient (6.26 per cent).

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.

scholarly journals Trifurcation of the right common carotid artery

2008 ◽  
Vol 41 (01) ◽  
pp. 85-88
Author(s):  
R. Chitra
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Lateral Position ◽  
External Carotid Artery ◽  
External Carotid ◽  
Occipital Artery ◽  
Branching Pattern ◽  
Male Cadaver ◽  
The Right ◽  
Common Carotid Arteries

ABSTRACTVariations in the position of the bifurcation of the common carotid artery and the origin or branching pattern of the external carotid artery are well known and documented. Here, we report the trifurcation of the right common carotid artery in a male cadaver aged about 55 years. The right common carotid artery was found to divide into the external and internal carotids and the occipital artery. High division of bilateral common carotid arteries and a lateral position of the right external carotid artery at its origin were also observed in the same cadaver. There were two ascending pharyngeal arteries on the right side - one from the occipital artery and another from the internal carotid artery. The intraarterial approach is one of the most important routes for the administration of anticancer drugs for head and neck cancers. A profound knowledge of the anatomical characteristics and variations of the carotid artery such as its branching pattern and its position is essential to avoid complications with catheter insertion.

Revisiting carotid endarterectomy: Neobulb technique using external carotid artery as a patch

Vascular ◽  
2021 ◽  
pp. 170853812110523
Author(s):  
Adalberto P Araujo ◽  
Cristiane F Araujo‐Gomes ◽  
Douglas Poschinger-Figueiredo ◽  
Carlos Felipe S Delgado ◽  
Monica R Mayall ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Bifurcation ◽  
External Carotid Artery ◽  
External Carotid ◽  
Long Term Follow Up ◽  
Distal Flow

Objectives This study describes an alternative carotid bifurcation endarterectomy technique in which the external carotid artery is used as a suture patch. Methods Charts of ten patients with atherosclerotic carotid stenosis that were treated using the neobulb technique between 2002 and 2019 were reviewed. Results No major surgical adverse event was observed in the postoperative assessments. No postoperative common or internal carotid stenosis was observed in the mid- or long-term follow-up. Conclusions The neobulb technique allows carotid endarterectomy closure without a synthetic or venous patch, using the external carotid artery as an autologous patch, while preserving distal flow into the external carotid artery branches.

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