Aberrant extracranial internal carotid arteries: New insights, implications, and demand for a clinical grading system

Pfeiffer, Jens; Becker, Christoph; Ridder, Gerd Jürgen

doi:10.1002/hed.24071

Cited by 31 publications

(66 citation statements)

References 21 publications

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“…On the other hand, DA has been more frequently observed in male patients, particularly in studies including cases of intracranial DA. 1,5,15,16 However, the present study included cases of extracranial DA and, thus, this discrepancy may be due to the histological and immunological differences associated with the extracranial arterial system. Of the studied …”

Section: Discussionmentioning

confidence: 55%

Matrix Metalloproteinase Levels in Cervical and Intracranial Carotid Dolichoarteriopathies

Arslan

Pekçevik

et al. 2016

Journal of Stroke and Cerebrovascular Diseases

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Section: Discussionmentioning

confidence: 55%

Matrix Metalloproteinase Levels in Cervical and Intracranial Carotid Dolichoarteriopathies

Arslan

Pekçevik

et al. 2016

Journal of Stroke and Cerebrovascular Diseases

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“…In the literature, it is possible to read previously reported several anatomic variations of ICAs. Prominent parapharyngeal ICA anomalies can be found in up to 5% of the general population and may place the artery into close correlation with the pharyngeal wall, where it is at risk of damage particularly during surgical interventions [1, 3]. Tortuous ICA, ICA located in the tympanic cavity, a retropharyngeal course of an ICA, and carotid bifurcation's absence that resulted an ICA agenesis are described ICA anomalies [4–7].…”

Section: Discussionmentioning

confidence: 99%

“…There are two provoking factors that appear to play a role in the development of ICA aberrations: age-related degenerative changes in the vessel wall and embryological maldevelopment, as well as the combination of both [3]. Because, in young children, pronounced kinking and coiling can also be found often bilaterally with the same age-independent incidence, a congenital malformation seems likely.…”

Section: Discussionmentioning

confidence: 99%

“…During embryological development, a loop is formed at the junction of the ICAs and the third paired dorsal aortae which is the origin of these vessels. While the heart is descending into the mediastinum, this loop usually uncoils, but aberrations in this step may inhibit straightening of the artery and end in an anomalic ICA that mostly shows an anteromedial tortuosity at the level of the oropharynx [3]. Extracranial ICA anomalies are clinically silent in the most of cases.…”

Section: Discussionmentioning

confidence: 99%

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Tortuous Carotid Artery Extended to Neck Level IIb Mimicking the Metastatic Mass

Uzun

Eğilmez

Kalcıoğlu

et al. 2016

Case Reports in Otolaryngology

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Specifically in neck level IIb, the expected normal anatomy does not contain any vital structures and consequently it might direct a surgeon to perform rapid surgical dissection of tissues. Therefore aberrant anatomy of the vessels in the patients may be overlooked during neck dissection. Unexpected and potentially devastating injuries can be avoided by respecting the possible aberrant anatomy in any level of the neck. In this case report, a 74-year-old man was presented with laryngeal carcinoma who was treated with laryngectomy and bilateral neck dissection. During the left side neck dissection, tortuous internal carotid artery imitating a metastatic mass was unexpectedly encountered in level IIb. As in this case, surgeons should keep in mind possible aberrant anatomy during the neck dissection and perform surgery staying in surgical principles to be safe for an unforeseen and potential dangerous injuries.

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“…Their measurements were based on slice data and did not use curvature or torsion to characterize vessel tortuosity. In another study, Jens et al studied abnormal extracranial ICAs and used lateral cervical displacement to determine tortuosity [16]. Studies by Grisan et al and Shelton et al concerning vessel tortuosity measurements used retinal blood vessels to calculate the ratio of arc length to chord length and curvature [17, 18].…”

Section: Introductionmentioning

confidence: 99%

Skeleton-based cerebrovascular quantitative analysis

et al. 2016

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BackgroundCerebrovascular disease is the most common cause of death worldwide, with millions of deaths annually. Interest is increasing toward understanding the geometric factors that influence cerebrovascular diseases, such as stroke. Cerebrovascular shape analyses are essential for the diagnosis and pathological identification of these conditions. The current study aimed to provide a stable and consistent methodology for quantitative Circle of Willis (CoW) analysis and to identify geometric changes in this structure.MethodAn entire pipeline was designed with emphasis on automating each step. The stochastic segmentation was improved and volumetric data were obtained. The L1 medial axis method was applied to vessel volumetric data, which yielded a discrete skeleton dataset. A B-spline curve was used to fit the skeleton, and geometric values were proposed for a one-dimensional skeleton and radius. The calculations used to derive these values were illustrated in detail.ResultIn one example(No. 47 in the open dataset) all values for different branches of CoW were calculated. The anterior communicating artery(ACo) was the shortest vessel, with a length of 2.6mm. The range of the curvature of all vessels was (0.3, 0.9) ± (0.1, 1.4). The range of the torsion was (−12.4,0.8) ± (0, 48.7). The mean radius value range was (3.1, 1.5) ± (0.1, 0.7) mm, and the mean angle value range was (2.2, 2.9) ± (0, 0.2) mm. In addition to the torsion variance values in a few vessels, the variance values of all vessel characteristics remained near 1. The distribution of the radii of symmetrical posterior cerebral artery(PCA) and angle values of the symmetrical posterior communicating arteries(PCo) demonstrated a certain correlation between the corresponding values of symmetrical vessels on the CoW.ConclusionThe data verified the stability of our methodology. Our method was appropriate for the analysis of large medical image datasets derived from the automated pipeline for populations. This method was applicable to other tubular organs, such as the large intestine and bile duct.Electronic supplementary materialThe online version of this article (doi:10.1186/s12880-016-0170-8) contains supplementary material, which is available to authorized users.

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Aberrant extracranial internal carotid arteries: New insights, implications, and demand for a clinical grading system

Abstract: Aberrant ICAs are underestimated anatomic variations with high clinical impact for transoral and transcervical interventions. The introduced clinicoradiologic grading system could be of major benefit. © 2015 Wiley Periodicals, Inc. Head Neck 38: E687-E693, 2016.

Cited by 31 publications

References 21 publications

Matrix Metalloproteinase Levels in Cervical and Intracranial Carotid Dolichoarteriopathies

Matrix Metalloproteinase Levels in Cervical and Intracranial Carotid Dolichoarteriopathies

Tortuous Carotid Artery Extended to Neck Level IIb Mimicking the Metastatic Mass

Skeleton-based cerebrovascular quantitative analysis

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