West C T, Brassett C, Gaunt M E
University of Cambridge.
Folia Morphol (Warsz). 2018;77(4):693-697. doi: 10.5603/FM.a2018.0017. Epub 2018 Mar 3.
The carotid sinus (CS) is a dilatation in the carotid bifurcation usually at the origin of proximal internal carotid artery (ICA). It contains baroreceptors which influence blood pressure. Variations in the location of the CS are of importance as atheromatous plaque commonly forms in this area and procedures such as carotid endarterectomy are performed to reduce the risk of stroke. Inadvertent stimulation of the CS baroreceptors during interventions can have profound effects on the patient's haemodynamic status both intra- and postoperatively, causing serious complications. The aim of this study is to determine the inter- and intra-individual variations in the location of the CS.
Eighty-two carotid arteries were dissected bilaterally from 41 cadavers. The locations of the CS were noted and divided into four potential sites.
The commonest site is the origin of the ICA (74.3%), but the CS can also be found in the distal part of the common carotid artery (CCA) inferior to the bifurcation (17.1%); at the bifurcation involving the distal CCA and origins of both the external carotid artery (ECA) and ICA (7.32%); and at the origin of the ECA (1.22%). In individual cadavers, the CS was located at the origin of the ICA in 97.6% on at least one side. The sites of the CS were asymmetrical in 34.1%.
Clinicians performing carotid interventions should be aware of these anatomical variations to avoid inadvertent stimulation of the CS which can cause profound bradycardia and hypotension.
颈动脉窦（CS）是颈动脉分叉处的一个扩张部位，通常位于颈内动脉（ICA）近端的起始处。它包含压力感受器，可影响血压。由于该区域常形成动脉粥样硬化斑块，且会进行颈动脉内膜切除术等手术以降低中风风险，因此颈动脉窦位置的变异具有重要意义。在干预过程中意外刺激颈动脉窦压力感受器可对患者术中及术后的血流动力学状态产生深远影响，导致严重并发症。本研究的目的是确定颈动脉窦位置的个体间和个体内变异。
从41具尸体上双侧解剖82条颈动脉。记录颈动脉窦的位置，并将其分为四个潜在部位。
最常见的位置是颈内动脉起始处（74.3%），但颈动脉窦也可位于分叉下方颈总动脉（CCA）的远端（17.1%）；位于涉及颈总动脉远端以及颈外动脉（ECA）和颈内动脉起始处的分叉处（7.32%）；以及颈外动脉起始处（1.22%）。在个体尸体中，至少一侧的颈动脉窦位于颈内动脉起始处的占97.6%。颈动脉窦的位置在34.1%的个体中不对称。
进行颈动脉干预的临床医生应了解这些解剖变异，以避免意外刺激颈动脉窦，从而导致严重的心动过缓和低血压。
