Orellana-Donoso Mathias, Sanchis-Gimeno Juan, Afandi-Rebolledo Sary, Nova-Baeza Pablo, García-Mena Paloma, Suazo-Santibañez Alejandra, Peñailillo-Ibarra Rocío, Valdés-Orrego Iván, Valenzuela-Fuenzalida Juan José
Escuela de Medicina, Universidad Finis Terrae, 7501015, Santiago, Chile.
Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile.
Anat Sci Int. 2025 Aug 6. doi: 10.1007/s12565-025-00873-y.
The internal carotid artery (ICA) is a crucial vessel, and its congenital absence, known as ICA agenesis, is a rare vascular anomaly. This systematic review aimed to provide a comprehensive overview of the available evidence on this condition. We systematically searched multiple databases from inception until January 2024. Two authors independently screened titles and abstracts, and a third reviewer was involved if consensus could not be reached. Data extraction and quality assessment were performed using validated the AQUA tool and the JBI critical appraisal checklist tool. A total of 138 (7.8%) articles out of 1,778 met the inclusion criteria, reporting 2040 subjects from which 176 presented (8.6%) ICA agenesis. Most of the studies were case reports (96%), and the included studies originated from various countries, with the United States (17.39%), Japan (14.49%), Turkey (10.87%), and India (10.14%) contributing the most. Left-sided agenesis was the most common (67.39%), followed by right-sided (42.03%) and bilateral (22.46%) agenesis. The most reported clinical manifestations were Horner's syndrome, increased risk of intracranial aneurysms, and pituitary gland abnormalities. ICA agenesis is a rare vascular anomaly with a left-sided predominance. While some patients may develop associated clinical conditions, many remain asymptomatic due to the development of robust collateral circulation. Comprehensive preoperative evaluation and awareness of these anatomical variations are crucial to guide surgical planning and minimize the risk of complications. PROSPERO registration number: CRD42024592673.
颈内动脉（ICA）是一条重要血管，其先天性缺失，即颈内动脉发育不全，是一种罕见的血管异常。本系统评价旨在全面概述关于这种情况的现有证据。我们系统检索了多个数据库，从建库至2024年1月。两名作者独立筛选标题和摘要，若无法达成共识，则由第三位评审员参与。使用经过验证的AQUA工具和JBI批判性评价清单工具进行数据提取和质量评估。在1778篇文章中，共有138篇（7.8%）符合纳入标准，报告了2040名受试者，其中176名（8.6%）存在颈内动脉发育不全。大多数研究为病例报告（96%），纳入的研究来自不同国家，其中美国（17.39%）、日本（14.49%）、土耳其（10.87%）和印度（10.14%）贡献最多。左侧发育不全最为常见（67.39%），其次是右侧（42.03%）和双侧（22.46%）发育不全。最常报告的临床表现为霍纳综合征、颅内动脉瘤风险增加和垂体异常。颈内动脉发育不全是一种罕见的血管异常，以左侧为主。虽然一些患者可能会出现相关临床情况，但由于强大的侧支循环发育，许多患者仍无症状。全面的术前评估以及对这些解剖变异的认识对于指导手术规划和降低并发症风险至关重要。PROSPERO注册号：CRD42024592673。
