IJAR.2024.193
Type of Article: Original Research
Volume 12; Issue 4 (December 2024)
Page No.: 9042-9048
DOI: https://dx.doi.org/10.16965/ijar.2024.193
A Study on Position and Lumen Geometry at the Origin of External Carotid Artery in Human Adult Cadavers
Pushyami Peruri *1, P.V.Chandrika 2, Sajja Keerthi Vathsalya 3, B.Naveen Kumar 4.
1 Associate professor, Department of Anatomy, Mamatha academy of medical sciences, Bachupally, Hyderabad, Telangana, India.
2 Associate professor, Department of Anatomy, Government Medical College, Eluru, Andhra Pradesh, India.
3 Tutor, Department of Anatomy, Mamatha Academy of Medical Sciences, Bachupally Hyderabad, India.
4 Professor, Department of Anatomy, Mamatha Academy of Medical Sciences, Bachupally, Hyderabad, Telangana, India.
Corresponding Author: Dr. Pushyami Peruri, Associate Professor, Department of Anatomy, Mamatha Academy of Medical Sciences, Bachupally, Hyderabad, Telangana, India. E-Mail: dr.pushyami@gmail.com
ABSTRACT
Background: External carotid artery is the predominant source of blood supply to the structures in the head and neck region. Morphological anomalies in the external and internal carotid arteries may lead to severe complications, when radiographic evaluations and surgical proceedings are done in the neck without any prior knowledge. Normal arterial diameters of external carotid arteries were important in-patient selection, preoperative planning, and design of new endovascular devices for arterial reconstruction.
Material and Methods: A descriptive study was performed on 60 formalin fixed male and female Human adult cadavers, aged between 45 to 75 yrs in the department of Anatomy, Dr.Pinnamaneni Siddhartha Institute of Medical Sciences and Research foundation, chinoutapalli and Mamatha academy of medical sciences, Hyderabad , during the academic years, 2018- 2023 during the academic years . Observations from both right and left external carotid arteries (total- 120 sides) were noted.
Results: In the present study, positions of external carotid artery observed were, antero-medial in 90%, anterolateral in 6.66% and lateral position in 3.33% of cases. The mean ± standard deviation calculated for the diameter of lumen at the origin of external carotid artery on the right side was 0.623±0.048 cm and on the left side was 0.608±0.050cm. For both right and left sides was 0.616±0.049cm.
Conclusion: Positional variations of external carotid artery observed in the present study were anterolateral and lateral positions. In such cases Carotid endarterectomy can be safely done, after transposing the internal carotid artery to normal location. Data on normal arterial diameters were helpful during reconstructive surgeries and manufacture of endovascular devices, respective to different ethnic groups.
Keywords: Common Carotid Artery, Carotid Artery External, Positional Variations, Lumen Geometry, Carotid Endarterectomy.
REFERENCES
[1]. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 39th Edition. Susan Standring. London :Churchill Livingstone; 2005.
[2]. Shang JB, Li YH, Chen Y et al. Clinical application of transarterial embolization for massive hemorhhage in the nasopharyngeal and maxillofacial regions. Di Yi Jun Yi Da Xue Xue Bao .2004; 24(2):210-2.
[3]. Ito M, Niiya Y, Kojima M, et al. Lateral position of the external carotid artery: a rare variation to be recognized during carotid endarterectomy. Acta Neurochir Suppl.2016;123: 115-122.
https://doi.org/10.1007/978-3-319-29887-0_16
PMid:27637637
[4]. Giustino M, Federico A, Roberto G, Roberto A, Alessandro G, Giordano et al. Complete transposition of carotid bifurcation: can it be an additional risk factor of injury to the cranial nerves during carotid endarterectomy. Interact Cardiovasc Thorac Surg. 2011;13: 471-474.
https://doi.org/10.1510/icvts.2011.272914
PMid:21873365
[5]. Kamide T, Nomura M, Tamase A, Mori k,Seki S, Kitamura Y et al. Simple classification of carotid bifurcation: is it possible to predict twisted carotid artery during carotid endarterectomy? Acta Neurochir (Wien).2016;158: 2393-2397.
https://doi.org/10.1007/s00701-016-2948-4
PMid:27614435
[6]. Tokugawa J, Kudo K, Mitsuhashi T, Yanagisawa N, Nojiri S, Hishii M. Surgical results of carotid endarterectomy for twisted carotid bifurcation. World Neurosurg .2019 Jun; 126:e153- e156.
https://doi.org/10.1016/j.wneu.2019.01.282
PMid:30794973
[7]. Masaaki UNO, Yagi K, Takai H, Hara K, Oyama N, Yagita Y. Diagnosis and Operative Management of Carotid Endarterectomy in Patients with Twisted Carotid Bifurcation. Neurol Med Chir .2020; 60:383-389.
https://doi.org/10.2176/nmc.oa.2020-0047
PMid:32669526 PMCid:PMC7431872
[8]. Bailey MA, Scott DJA, Tunstall RG, Gough MJ. Lateral External Carotid Artery: Implications for the Vascular Surgeon. Eur J Vasc Endovasc Surg. 2007 Oct; 14( 2) : 22- 24.
https://doi.org/10.1016/j.ejvsextra.2007.03.005
[9]. Kamenskiy AV, MacTaggart JN, Bikhchandani J, Dzenis YA . Three-dimensional geometry of the human carotid artery. J Biomech Eng. JUNE 2012 Jun; 134: 064502-1- 7.
https://doi.org/10.1115/1.4006810
PMid:22757506 PMCid:PMC5413160
[10]. Sitzer M, Puac D, Buehler A, Steckel DA, Von Kegler S, Markus HS, Steinmetz H. Internal carotid artery angle of origin: a novel risk factor for early carotid atherosclerosis. Stroke. 2003;34:950 -955.
https://doi.org/10.1161/01.STR.0000060895.38298.C4
PMid:12637694
[11]. Michalinos A, Chatzimarkos M, Arkadopoulos N, Safioleas M, Troupis T. Anatomical considerations on surgical anatomy of the carotid bifurcation. Anatomy research international. 2016;Vol 2016. 8pages. http://dx.doi.org/10.1155/2016/6907472
https://doi.org/10.1155/2016/6907472
PMid:27047690 PMCid:PMC4800075
[12]. Romanes GJ. Cunningham’s manual of dissection. vol 3. South Asia edition,15th edition. Oxford university press; 1986.
[13]. Handa J, Matsuda M, Handa H. Lateral position of the external carotid artery. Report of a case. Radiology.1972; 102 : 361-362.
https://doi.org/10.1148/102.2.361
PMid:4536689
[14]. AnithaT , JayasreeN , Asha K , Dombe D. A rare anatomical variant of the external carotid artery. Int J Curr Res Acad Rev. 2011 Apr;3 (4 ):29- 33.
[15]. Acar M; Salbacak A, Sakarya ME, Zararsi I, Ulusoy M. The morphometrical analysis of the external carotid artery and ıts branches with multidetector computerized tomography angiography technique. Int. J. Morphol.2013; 31(4):1407-1414.
https://doi.org/10.4067/S0717-95022013000400042
[16]. Masaki ITO, Niiya Y, Kojima M, Itosaka H, Iwasaki M, Kazumata K. Lateral Position of the External Carotid Artery: A Rare Variation to Be Recognized During Carotid Endarterectomy. Acta Neurochir suppl. 2016;123:115-22.
https://doi.org/10.1007/978-3-319-29887-0_16
PMid:27637637
[17]. Krmpotić-Nemanić J. Anatomy variations and malformations of the head and neck. Arch Oto-RhinoLaryingol. 1978;219:1-91.
https://doi.org/10.1007/BF00456574
PMid:580737
[18]. Lucev N, Bobinac D, Mari IC, Dre scik I. Variations of ‘ the great arteries in the carotid triangle. Otolaryngol Head Neck Surg . 2000; 122(4): 590-591.
https://doi.org/10.1016/S0194-5998(00)70109-4
https://doi.org/10.1067/mhn.2000.97982
PMid:10740186
[19]. Delic J, Bajtarevic A, Isakovic E. Positional variations of the external and the internal carotid artery. Acta Med Salin. 2010;39:86-89.
[20]. Al-Rafiah A, El-Haggagy A, Aal IHA, Zaki AI. Anatomical study of the carotid bifurcation and origin variations of the ascending pharyngeal and superior thyroid arteries. Folia Morphol . 2011; 70( 1): 47-55.
[21]. Larsen W. Human Embryology. New York: Churchill Livingstone, 2nd edition.1998: 191-195.
[22]. B. Desai, J.F. Toole. Kinks, coils, and carotids: a review. Stroke. 6th edition.1975: 649-653.
https://doi.org/10.1161/01.STR.6.6.649
PMid:1198629
[23]. Ozdemir H, Artas H, Serhatlioglu S, Ogur E. Effects of overweight on luminal diameter, flow velocity and intima-media thickness of carotid arteries. Diagn. Interv. Radiol.2006; 12(3):142-6
[24]. Goldstein LB, Samsa GP, Matchar DB, Oddone EZ. Multicenter review of preoperative risk factors for endarterectomy for asymptomatic carotid artery stenosis. Stroke. 1998;29:750-753.
https://doi.org/10.1161/01.STR.29.4.750
PMid:9550506
[25]. Ribeiro RA, Ribeiro JAS, Filho OAR, Caetano AG, SassoliFazan VPRA. Common Carotid Artery Bifurcation Levels Related to Clinical Relevant Anatomical Landmarks. Int.J.Morphol. 2006; 24(3): 413-416.
https://doi.org/10.4067/S0717-95022006000400019
[26]. Kpuduwei SPK, Kiridi EK, Fawehinmi HB, Oladipo GS. Reference luminal diameters of the carotid arteries among healthy Nigerian adults. Folia Morphol. 2021-06-14.
https://doi.org/10.5603/FM.a2021.0062
PMid:34184750
[27]. Kirkwood B, Sterne J. Essential Medical Statistics. Blackwell Publishing Ltd 2nd Edition ; 2003. 56-57 p.
[28]. Lawless J, Fredette M. Frequentist prediction intervals and predictive distributions. Biometrik. 2005;92(3):529-542.
https://doi.org/10.1093/biomet/92.3.529
