Uchino Akira, Saito Naoko, Okada Yoshitaka, Kozawa Eito, Nishi Naoko, Mizukoshi Waka, Nakajima Reiko, Takahashi Masahiro, Watanabe Yusuke
Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
Surg Radiol Anat. 2013 May;35(4):339-42. doi: 10.1007/s00276-012-1038-4. Epub 2012 Nov 6.
The left common carotid artery (LCCA) is usually a second branch of the aortic arch that arises between the brachiocephalic trunk (BCT) and left subclavian artery; relatively frequently, it also arises from or shares a common origin with the BCT. In patients with LCCA of anomalous origin, transfemoral catheterization into the LCCA is sometimes difficult, and transbrachial or transradial approach may be recommended. We evaluated the prevalence of these variations on computed tomography (CT) angiography.
We retrospectively reviewed CT angiographic images of 2,357 patients obtained using either of two 64-slice multidetector CT scanners. All patients were Japanese and underwent scanning from the aortic arch to the intracranial region; most had or were suspected of having cerebrovascular diseases.
We evaluated CT angiographic images of 2,352 patients after excluding four patients with LCCA occluded at its origin. The LCCA arose from the BCT in 141 patients (6.0 %) and had a common origin with the BCT in 130 patients (5.5 %). We found 11 aberrant right subclavian artery (0.47 %), and four of the 11 patients (36 %) had LCCA of common origin with the right common carotid artery, forming a bicarotid trunk (prevalence: 0.17 %).
The total prevalence of variations of LCCA origin diagnosed by CT angiography was 11.7 %.
左颈总动脉（LCCA）通常是主动脉弓的第二个分支，起自头臂干（BCT）和左锁骨下动脉之间；相对常见的是，它也起自头臂干或与头臂干有共同起源。对于左颈总动脉起源异常的患者，经股动脉导管插入左颈总动脉有时会很困难，可能会推荐经肱动脉或经桡动脉途径。我们评估了计算机断层扫描（CT）血管造影中这些变异的发生率。
我们回顾性分析了使用两台64层多层螺旋CT扫描仪之一获得的2357例患者的CT血管造影图像。所有患者均为日本人，扫描范围从主动脉弓至颅内区域；大多数患者患有或疑似患有脑血管疾病。
排除4例左颈总动脉起始处闭塞的患者后，我们评估了2352例患者的CT血管造影图像。141例患者（6.0%）的左颈总动脉起自头臂干，130例患者（5.5%）的左颈总动脉与头臂干有共同起源。我们发现11例异常右锁骨下动脉（0.47%），其中11例患者中有4例（36%）的左颈总动脉与右颈总动脉有共同起源，形成双颈动脉干（发生率：0.17%）。
CT血管造影诊断的左颈总动脉起源变异的总发生率为11.7%。
