Author:
Manta Mihaela Daniela,Rusu Mugurel Constantin,Hostiuc Sorin,Tudose Răzvan Costin,Manta Bogdan Adrian,Jianu Adelina Maria
Abstract
Abstract
Purpose
The vertical level of carotid bifurcation (CB) is commonly indicated at the superior margin of the thyroid cartilage. Few studies observed the CB vertical topography. It was aimed at studying the vertical location of the CB as referred to vertebral and anterior cervical landmarks.
Methods
An archived lot of 147 computed tomography angiograms was documented for the vertical level of CB referred to vertebral and anterior cervical landmarks. The topography of the CB in relation to anterior landmarks was classified into seven types: (1) at the superior margin of the thyroid cartilage; (2) between the hyoid and the thyroid cartilage; (3) at the hyoid level; (4) between the hyoid and mandible; (5) subgonial or supragonial CB; (6) lower cervical level; (7) intrathoracic.
Results
The most common locations of CB were at C3 (27.21%), C3/C4 (26.19%) and C4 (25.51%). Bilateral symmetry of CB was found in 51.7%, except for C2 and C5/C6. Type 7 was not found, type 3 occurred in 39.12%, type 2 in 24.49%, type 1 in 13.95%, type 4 in 13.61%, type 5 in 6.12%, and type 6 in 2.72% (294 CBs). Bilateral symmetry of anterior types was found in 59.86%. Statistically significant correlations were found between sex and both left and right types and vertebral levels of CB.
Conclusions
The vertical topography of the CB is highly variable and has sex-related specificity. This detail should be included in the teaching of anatomy. Surgeons and interventionists should better document the carotid anatomy on a case-by-case basis.
Publisher
Springer Science and Business Media LLC
Reference37 articles.
1. Acar M, Salbacak A, Sakarya ME, Zararsiz I, Ulusoy M (2013) Análisis Morfométrico De La Arteria Carótida Externa Y sus Ramas Mediante La Técnica De Angiografía Por Tomografía Computarizada Multidetector. Int J Morphol 31:1407–1414
2. Ambali M, Jadhav S (2012) Variations in bifurcation point and branching pattern of common carotid arteries: a cadaveric study. J Pharm Biomed Sci 25:147–151
3. Anangwe D, Saidi H, Ogeng’o J, Awori KO (2008) Anatomical variations of the carotid arteries in adult kenyans. East Afr Med J 85:244–247. https://doi.org/10.4314/eamj.v85i5.9619
4. Anu VR, Pai MM, Rajalakshmi R, Latha VP, Rajanigandha V, D’Costa S (2007) Clinically-relevant variations of the carotid arterial system. Singap Med J 48:566–569
5. Arumugam S, Subbiah NK (2020) A cadaveric study on the course of the cervical segment of the Internal Carotid Artery and its variations. Cureus 12:e7663. https://doi.org/10.7759/cureus.7663