Extreme low-lying carotid bifurcations

Harwood, Amy E.; Leung, Clement C. M.; Smith, George E.; Chetter, Ian C.

Abstract

A 52-year-old male with no past medical history was referred to the transient ischaemic attack (TIA) clinic following an event at home. The transient symptoms were of an inability to move his left arm and leg for a period of approximately 15 minutes. The patient denied any numbness of the face, headaches or blurring of vision. A careful history revealed two previous transient attacks of blurred vision approximately 1–2 years prior to this presentation. He had no other co-morbidities or associated syndromes. Given this history, suggestive of TIA(s) in the right anterior circulation, an ultrasound examination of the carotid vessels was performed to include or exclude an atherosclerotic source of embolus. The ultrasound scan demonstrated an extremely short common carotid artery (CCA) of just 2.5 cm on the right, with apparently normal flows and velocities in both the external and internal carotids (ECA and ICA) but poor views of the bifurcation. Similarly, the flows and velocities in the left ICA and ECA were also normal, with the carotid bulb lying low in the base of the neck, so further imaging with a magnetic resonance angiogram (MRA) was performed (Panel A) to clarify the anatomic and ultrasound findings. This confirmed extremely low-lying bilateral carotid bifurcations (highlighted in Panel A). The short, right-side CCA bifurcates at the level of C7/T1 (Panel B) and the left carotid bifurcation is at the level of C6/C7 (Panel C).

Citation

Harwood, A. E., Leung, C. C. M., Smith, G. E., & Chetter, I. C. (2016). Extreme low-lying carotid bifurcations. Vascular Medicine, 21(4), 394-395. https://doi.org/10.1177/1358863X15627208

• Journal Article Type: Article
• Acceptance Date: Dec 22, 2015
• Online Publication Date: Feb 5, 2016
• Publication Date: 2016-08
• Deposit Date: Apr 19, 2016
• Publicly Available Date: Apr 19, 2016
• Journal: Vascular medicine
• Print ISSN: 1358-863X
• Electronic ISSN: 1477-0377
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Issue: 4
• Pages: 394-395
• DOI: https://doi.org/10.1177/1358863X15627208
• Keywords: Carotid artery, Anatomical variant
• Public URL: https://hull-repository.worktribe.com/output/436344
• Publisher URL: http://vmj.sagepub.com/content/early/2016/02/04/1358863X15627208
• Additional Information: Author's accepted manuscript of article published in: Vascular medicine, 2016.