Ramputi Lucia, Mazzaccaro Daniela, Tissir Karima, Trevisan Manuel Bruno, Conte Gianluca, Nano Giovanni, Menicanti Lorenzo, Castelvecchio Serenella
Department of Cardiovascular Prevention and Gender Medicine, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
Operative Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
Vascular. 2024 Sep 18;33(5):17085381241283095. doi: 10.1177/17085381241283095.
Anatomical variations of origin of the internal carotid artery (ICA) are very uncommon and may pose a diagnostic and therapeutic challenge.
We report a case of direct origin of the right ICA from the innominate artery (aplasia of common carotid artery) and a case of duplication of right ICA in healthy patients who performed duplex ultrasound (DUS) for primary cardiovascular prevention screening.
In both cases, the ultrasound scan was performed both in a transverse plane and on the longitudinal axis, and in one of the two cases, a computed tomography angiography was performed to confirm the diagnosis. A review of the current literature about anatomical variations of origin of carotid arteries was also performed.
The most frequent congenital anomaly is represented by the aplasia of the CCA, followed by the agenesis and by the duplication of the ICA. In most cases, the anomaly is discovered occasionally and symptoms are aspecific. Diagnosis is usually confirmed through a multimodality imaging approach, including DUS of extracranial carotid arteries, magnetic resonance imaging (MRI), and computed tomographic angiography. In most cases, treatment was conservative, with pharmacological therapy aimed at the symptoms.
The recognition of such variations is mandatory, particularly when the patient needs a surgical treatment that may involve the vessel with the anatomical variations.
颈内动脉（ICA）起源的解剖变异非常罕见，可能对诊断和治疗构成挑战。
我们报告了2例在进行双功超声（DUS）进行原发性心血管预防筛查的健康患者中，右侧ICA直接起源于无名动脉（颈总动脉发育不全）的病例以及1例右侧ICA重复的病例。
在这2例病例中，均在横断面上和纵轴上进行了超声扫描，并且在2例中的1例中，进行了计算机断层血管造影以确诊。还对当前有关颈动脉起源解剖变异的文献进行了综述。
最常见的先天性异常是颈总动脉发育不全，其次是ICA缺如和ICA重复。在大多数情况下，该异常是偶然发现的，症状不具特异性。诊断通常通过多模态成像方法来确认，包括颅外颈动脉的DUS、磁共振成像（MRI）和计算机断层血管造影。在大多数情况下，治疗是保守的，采用针对症状的药物治疗。
认识到这种变异是必不可少的，特别是当患者需要进行可能涉及有解剖变异血管的手术治疗时。
