A rare case of absent left common carotid artery with bovine origin of the left external carotid artery

Abstract

A 22-year-old man had cerebral venous sinus thrombosis and his angiogram incidentally revealed an absent left common carotid artery with bovine origin of the left external carotid artery. There was also an associated low bifurcation of the right common carotid artery and basilar artery fenestration. The absence of a common carotid artery is a very rare angiographic finding, and an association with a bovine origin of the left external carotid artery has not been reported previously in the literature. Here we provide a description of the case along with a review of the literature and embryology.

Absence of right common carotid artery in a patient with common origin of the innominate artery and left common carotid artery

“…Absence of a common carotid artery was described by Malacarne in 1784. 5,8,9 Prevalence of such a finding is similar on the right or left and higher in women. 2,[10][11][12] In general, such anatomic variations do not cause symptoms and have been detected during imaging examinations.…”

“…The combination of absence of the common carotid artery with an abnormal aortic arch anatomy is an even rarer condition to be detected in a vascular clinic or ultrasound vascular laboratory, with a single case reporting the same variation although on the left side. [3][4][5][6][7] A case of an asymptomatic 50-year-old woman having carotid artery screening is reported herein because of the extreme rarity of the event: right common carotid artery absence together with a common origin of the innominate artery and left common carotid artery. The patient has agreed to have images and case details published.…”

Congenital Aplasia of the Common Carotid Artery: A Comprehensive Review

“…is trunk had a common origin with the le ECA only in one case [68]. However, it was the vascular source of the right ECA in 4/41 cases [14, LCAA: C +I+E+V+S+S [33] RCAA: B+V [71] RCAA: (C)+E +I +S + (S) [9] RCAA: (C+E )+I +S + (S) [77] RCAA: C+E +I +S + (S) [73,79] RCAA: (C)+E +I + (S ) [75] RCAA: C+E +I +S [34,36] RCAA: (C)+E +I +V +S +S [78] RCAA: LIA+I +E +S [80] [39, 74] F 6: Patterns of the branching of the ascending aorta, le -sided and right-sided cervical aortic arches, and descending aorta in cases of unilateral aplasia of the common carotid artery (CCA).…”

“…e patterns of the NAA branching were di erent in these cases; the number of these branches ranged from two [7,[52][53][54] to ve [18,[55][56][57]. Hovewer, the NAA with four branches was a more common nding associated with the le CCA aplasia [1,10,11,16,42,43,49,51,[58][59][60][61][62][63], than with the right [13,18,26] or bilateral CCA aplasia [38,64,65]; a pattern of the NAA with three branches was more common in the cases of the right CCA aplasia [5, 14, 15, 17-25, 27-29, 66], than in the cases of the le [67,68] or bilateral CCA aplasia [69] (Figure 5).…”

“…I A internal thoracic artery, ACA anterior cerebral artery, OPhA ophthalmic artery, BT brachiocephalic trunk, ECA external carotid artery, ICA internal carotid artery, SA subclavian artery, VA vertebral artery, TT thyrocervical trunk, PCoA posterior communicating artery, Al pre-communicating part of the ACA, PPIA persistent proatlantal intersegmental artery, PTAV persistent trigeminal artery variant, SVC superior vena cava, RCAA right-sided cervical aortic arch, DAA double aortic arch, LCAA le -sided cervical aortic arch, LIA le innominate artery, CcT costocervical trunk, MCA middle cerebral artery, NAA normal aortic arch, APhA ascending pharyngeal artery. Common origin of the BT and le ECA [68] Common origin of the le ICA and le SA [67] Common origin of the le ICA and le VA [87] [38] T 3: Presence and absence of pathoanatomical states in 87 cases with the common carotid artery (CCA) aplasia. a Pathological disorders and findings only alphabetically listed and do not indicate the number of cases, because they were multiple in some of the cases.Note: Some references are cited as follow: Quain [91], cited by Fife [45]; Malacarne [40], cited by Andrews and Howard, [6]; Gottschau [41], Von Angermayer [88], Smirnov [85], and Schmeidel [86], cited by Bryan et al [43]; Kosinski [66], cited by Boyd [14]; Merkel and Bonnet [89], cited By Warschewske and Benndorf [42]; Mullins et al [78], cited by Haughton et al [34]; Chang et al [76], cited by Shuford et al [39]; and Johnson et al [87], cited by Dahn et al [16].…”