Korean J Radiol.  2015 Aug;16(4):914-918. 10.3348/kjr.2015.16.4.914.

Anomalous External Carotid Artery-Internal Carotid Artery Anastomosis in Two Patients with Proximal Internal Carotid Arterial Remnants

• Kim CH
• Cho YD
• Kang HS
• Kim JE
• Jung SC
• Ahn JH
• Han MH

• KMID: 2155567
• DOI: http://doi.org/10.3348/kjr.2015.16.4.914

Abstract

Two angiographic instances of anomalous external carotid artery (ECA) and internal carotid artery (ICA) anastomosis are described, each occurring at the C2-3 level and bearing remnants of proximal ICA. The ICA remnant of one patient (identifiable immediately upon bifurcation of the common carotid artery) was hypoplastic, and that of the other patient was an occluded arterial stump. These features are not typical of non-bifurcating ICA. The occipital artery originated from an anomalous connection in one instance and from the main trunk of the ECA (just past the ECA-ICA connection) in the other.

Keyword

Non-bifurcating carotid artery; Anomalous anastomosis; Anatomical variation

MeSH Terms

Adult
Arterial Occlusive Diseases/radiography
Carotid Artery, External/*abnormalities/radiography/surgery
Carotid Artery, Internal/*abnormalities/radiography/surgery
Cerebral Angiography
Humans
Intracranial Aneurysm/*radiography/surgery
Male
Middle Aged

Figure

• 

  Fig. 1 44-year-old man with anomalous ECA-ICA anastomosis and hypoplastic proximal ICA. A, B. Frontal (A) and lateral (B) angiographic images showing anomalous ECA-ICA anastomosis at C2-3 spinal level and relatively hypoplastic proximal ICA at expected site of ICA origin. Anomalous anastomosis (white arrow), hypoplastic proximal ICA (arrowhead), and occipital artery (black arrow). ECA = external carotid artery, ICA = internal carotid artery

• 

  Fig. 2 60-year-old man with anomalous ECA-ICA anastomosis and proximal ICA remnant. A, B. Oblique (A) and lateral (B) angiographic images showing origins of ECA and ICA from common trunk, with carotid budding at carotid bifurcation level as probable remnant of proximal ICA. Anomalous anastomosis (white arrow), arterial stump (arrowhead), and occipital artery (black arrow). ECA = external carotid artery, ICA = internal carotid artery

• 

  Fig. 3 Schematic illustration of presented case in comparison with normal ICA-ECA development and non-bifurcating cervical carotid artery. A-C. Illustration for development of normal internal carotid artery and external carotid artery. D, E. Illustrations for typical non-bifurcating cervical carotid artery (D) and presented cases (E). a = artery, AI = first aortic arch, AII = second aortic arch, AIII = third aortic arch, AIV = forth aortic arch, CCA = common carotid artery, ECA = external carotid artery, ICA = internal carotid artery

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