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Dădârlat-Pop A, Molnar A, Oprea A, Tomoaia R, Boros B, Literat S, Serban A, Manole S. Imaging Challenges in the Diagnosis of Anatomical Variations of the Supra-Aortic Vessels: A Case Report and Review of Literature. Diagnostics (Basel) 2022; 12:diagnostics12010169. [PMID: 35054336 PMCID: PMC8774562 DOI: 10.3390/diagnostics12010169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 02/01/2023] Open
Abstract
A 73-year-old woman was referred to our Cardiology Department due to recurrent headaches and dizziness. She had a history of hypertension of 10 years. In the territorial hospital, left internal carotid artery significant stenosis was suspected. Neurological examination and laboratory tests were normal. A neck vascular ultrasound was performed, showing a low bifurcation of the left common carotid artery (CCA) and a hypoplastic left internal carotid artery (ICA) with a sinuous path at the cervical level. Therefore, a computed tomographic (CT) angiography examination of the head and neck vessels was performed. The images confirmed the presence of a hypoplastic left ICA, anatomic variation in the left CCA, and also showed that the left vertebral artery (VA) was stemming directly from the aortic arch, exhibiting a kinking trajectory.
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Affiliation(s)
- Alexandra Dădârlat-Pop
- Cardiology Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania; (A.D.-P.); (B.B.); (S.L.);
- Department of Cardiology, Iuliu Haţieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Adrian Molnar
- Cardiovascular Surgery Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania; (A.M.); (A.O.)
- Department of Cardiovascular Surgery, Iuliu Haţieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Alexandru Oprea
- Cardiovascular Surgery Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania; (A.M.); (A.O.)
- Department of Cardiovascular Surgery, Iuliu Haţieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Raluca Tomoaia
- Cardiology Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania; (A.D.-P.); (B.B.); (S.L.);
- Department of Cardiology, Iuliu Haţieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
- Correspondence:
| | - Bianca Boros
- Cardiology Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania; (A.D.-P.); (B.B.); (S.L.);
| | - Sorin Literat
- Cardiology Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania; (A.D.-P.); (B.B.); (S.L.);
| | - Adela Serban
- Cardiology Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania; (A.D.-P.); (B.B.); (S.L.);
- Department of Cardiology, Iuliu Haţieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Simona Manole
- Department of Radiology and Medical Imaging, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania;
- Department of Radiology and Medical Imaging, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj Napoca, 8, Victor Babes, St, 400012 Cluj-Napoca, Romania
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Ectopic origin of the ascending pharyngeal artery: implications for carotid surgery. Surg Radiol Anat 2018; 40:1181-1183. [PMID: 30128898 DOI: 10.1007/s00276-018-2088-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
Abstract
In its normal anatomy, the extracranial internal carotid artery (ICA) does not have branches. The most common cause of an extracranial ICA branch is the ectopic placement of one of the named external carotid artery branches. Other causes of extracranial ICA branches include persistent fetal carotid-vertebrobasilar anastomoses and recannalized intersegmental arteries. In this case, report we describe a 55-year-old male who was found to have an ascending pharyngeal artery (APA) arising from the ICA during neck dissection. The aberrant APA was not identified on pre-operative imaging. The patient underwent a successful carotid endarterectomy (CEA) with preservation of flow through the ascending pharyngeal. We review the literature on the origin of the APA and discuss the clinical implications of extracranial ICA branches.
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