DOI QR코드

DOI QR Code

Persisting carotid duct and proximal external carotid artery agenesis in an adult

  • Mugurel Constantin Rusu (Division of Anatomy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy) ;
  • Adelina Maria Jianu (Department of Anatomy, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy) ;
  • Alexandra Diana Vrapciu (Division of Anatomy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy) ;
  • Mihaela Daniela Manta (Department of Anatomy, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy)
  • Received : 2023.07.24
  • Accepted : 2023.11.29
  • Published : 2024.06.30

Abstract

The carotid duct (CD) is a transient embryological structure connecting the 3rd and 4th aortic arches. We found a persisting CD in an adult female case, by studying the computed tomography angiogram. On the left side, the proximal external carotid artery (ECA) agenesis was noted. The CD was inserted into the left subclavian artery and continued upwards to reach the level of the atlas, and then it descended to connect to a normally configured segment of that ECA. It could be speculated that the CD-to-ECA connection was possible via unregressed 1st and/or 2nd aortic arches. The segmental ECA agenesis is extremely rare, while its supply via a persisting patent CD was not reported previously to the authors' knowledge. The variants are extremely important during neck surgery because damaging the CD could determine hemorrhage, as well as ischemia in the ECA territory.

Keywords

References

  1. Rana MS, Sizarov A, Christoffels VM, Moorman AF. Development of the human aortic arch system captured in an interactive three-dimensional reference model. Am J Med Genet A 2014;164A:1372-83.
  2. Anderson RH, Bamforth SD. Morphogenesis of the mammalian aortic arch arteries. Front Cell Dev Biol 2022;10:892900.
  3. Sadler TW, Langman J. Langman's medical embryology. 12th ed. Wolters Kluwer Health/Lippincott Williams & Wilkins; 2012. 384 p.
  4. Devadas D, Pillay M, Sukumaran TT. Variations in the origin of superior laryngeal artery. Anat Cell Biol 2016;49:254-8.
  5. Suntratonpipat S, Bamforth SD, Johnson AL, Noga M, Anderson RH, Smallhorn J, Tham E. Childhood presentation of interrupted aortic arch with persistent carotid ducts. World J Pediatr Congenit Heart Surg 2015;6:335-8.
  6. Ekteish FM, Hajar R, Folger GM Jr. Persistence of third aortic arch with fourth aortic arch agenesis. Br Heart J 1986;55:607-9.
  7. Elumalai G, Chodisetty S, Usen BO, Patel RD. "patent ductus caroticus" embryological basis and its clinical significance. Elixir Physio Anat 2016;98:42439-42.
  8. Maybody M, Uszynski M, Morton E, Vitek JJ. Absence of the common carotid artery: a rare vascular anomaly. AJNR Am J Neuroradiol 2003;24:711-3.
  9. Waldo KL, Kumiski D, Kirby ML. Cardiac neural crest is essential for the persistence rather than the formation of an arch artery. Dev Dyn 1996;205:281-92.
  10. Padget DH. The development of the cranial arteries in the human embryo. Contrib embryol 1948;32:205-61.
  11. Hiruma T, Nakajima Y, Nakamura H. Development of pharyngeal arch arteries in early mouse embryo. J Anat 2002;201:15-29.
  12. Furtado SV, Quryshi SA, Jagannatha AT, Hegde AS. Segmental agenesis of external carotid artery from common carotid artery with anomalous reformation through occipital artery anastomoses. Neurol India 2021;69:1824-7.