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Anomalous Branch of the Internal Carotid Artery: An Ultrasonographic Curiosity

Anomalous Branch of the Internal Carotid Artery: An Ultrasonographic Curiosity Doppler Digest The Journal for Vascular Ultrasound 31(1):49, 2007 Anomalous Branch of the Internal Carotid Artery: An Ultrasonographic Curiosity Steven M. Dean, DO, FACP, RPVI; Joanne M. Fitzgerald, BS, RDCS, RDMS, RVT A 50-year-old woman with a history of diabetes mellitus, longstanding tobacco use, and hypertension presented for evaluation of asymptomatic bilateral ca- rotid arterial bruits. Duplex ultrasonography docu- mented heterogeneous plaque with <50% stenosis within the bilateral distal common carotid arteries and bulbs. Although the internal carotid arteries were rela- tively free of plaque, an unusual branch vessel was identified emanating from the proximal left internal carotid artery (Figure 1A). The peak systolic velocity of the aberrant artery was approximately 60 cm/sec and the waveform displayed high resistance charac- teristics (Figure 1B). Although distinctly uncommon, anomalous branches of the extracranial internal carotid artery (ICA) can occur. In 1876, Krause identified the follow- ing six ICA branches: occipital, lingual, superior laryn- geal, transverse facial, ascending pharyngeal, and ac- cessory ascending pharyngeal. Newton and Young documented an occipital artery branch from the extra- 2 3 cranial ICA. More recently, Brooks et al. reported a case of an aberrant ICA branch (ascending pharyngeal artery) that was functioning as a collateral conduit in the setting of a distal ICA occlusion . In the absence of an ipsilateral ICA occlusion, these anomalous branches appear clinically insignificant. Other than recommending tobacco cessation, anti- platelet therapy, and aggressive control of diabetes and hypertension, no further evaluation or treatment Figure 1 was suggested for the patient because the ICA branch was an innocuous finding. References 1. Krause W. Die varietan der arterien und venen. In: Henle J, From the Department of Cardiovascular Medicine, The Ohio State ed. Anatomie des menschen. 2nd ed, Vol 3, Pt 1. Braunschweig, University, Dorothy Davis Heart and Lung Research Institute, Co- Germany: F. Vieweg & Sohn; 1876. lumbus, Ohio. 2. Newton TH, Young DA. Anomalous origin of the occipital Address correspondence to: Steven M. Dean, DO, FACP, RPVI, artery from the internal carotid artery. Radiology. 1968;90:550–552. Assistant Professor of Clinical Medicine, Department of Cardiovas- cular Medicine, The Ohio State University, 200 Dorothy Davis Heart 3. Brooks AJ, Behm GM, Baxter BT, et al. Carotid string sign and Lung Research Institute, 473 W. 12th Avenue, Columbus, OH resulting from an aberrant branch of the internal carotid artery. J 43210. E-mail: steven.dean@osumc.edu. Cardiovasc Surg (Torino). 1998;39:163–165. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal for Vascular Ultrasound SAGE

Anomalous Branch of the Internal Carotid Artery: An Ultrasonographic Curiosity

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References (3)

Publisher
SAGE
Copyright
© 2007 Society for Vascular Ultrasound
ISSN
1544-3167
eISSN
1544-3175
DOI
10.1177/154431670703100110
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Abstract

Doppler Digest The Journal for Vascular Ultrasound 31(1):49, 2007 Anomalous Branch of the Internal Carotid Artery: An Ultrasonographic Curiosity Steven M. Dean, DO, FACP, RPVI; Joanne M. Fitzgerald, BS, RDCS, RDMS, RVT A 50-year-old woman with a history of diabetes mellitus, longstanding tobacco use, and hypertension presented for evaluation of asymptomatic bilateral ca- rotid arterial bruits. Duplex ultrasonography docu- mented heterogeneous plaque with <50% stenosis within the bilateral distal common carotid arteries and bulbs. Although the internal carotid arteries were rela- tively free of plaque, an unusual branch vessel was identified emanating from the proximal left internal carotid artery (Figure 1A). The peak systolic velocity of the aberrant artery was approximately 60 cm/sec and the waveform displayed high resistance charac- teristics (Figure 1B). Although distinctly uncommon, anomalous branches of the extracranial internal carotid artery (ICA) can occur. In 1876, Krause identified the follow- ing six ICA branches: occipital, lingual, superior laryn- geal, transverse facial, ascending pharyngeal, and ac- cessory ascending pharyngeal. Newton and Young documented an occipital artery branch from the extra- 2 3 cranial ICA. More recently, Brooks et al. reported a case of an aberrant ICA branch (ascending pharyngeal artery) that was functioning as a collateral conduit in the setting of a distal ICA occlusion . In the absence of an ipsilateral ICA occlusion, these anomalous branches appear clinically insignificant. Other than recommending tobacco cessation, anti- platelet therapy, and aggressive control of diabetes and hypertension, no further evaluation or treatment Figure 1 was suggested for the patient because the ICA branch was an innocuous finding. References 1. Krause W. Die varietan der arterien und venen. In: Henle J, From the Department of Cardiovascular Medicine, The Ohio State ed. Anatomie des menschen. 2nd ed, Vol 3, Pt 1. Braunschweig, University, Dorothy Davis Heart and Lung Research Institute, Co- Germany: F. Vieweg & Sohn; 1876. lumbus, Ohio. 2. Newton TH, Young DA. Anomalous origin of the occipital Address correspondence to: Steven M. Dean, DO, FACP, RPVI, artery from the internal carotid artery. Radiology. 1968;90:550–552. Assistant Professor of Clinical Medicine, Department of Cardiovas- cular Medicine, The Ohio State University, 200 Dorothy Davis Heart 3. Brooks AJ, Behm GM, Baxter BT, et al. Carotid string sign and Lung Research Institute, 473 W. 12th Avenue, Columbus, OH resulting from an aberrant branch of the internal carotid artery. J 43210. E-mail: steven.dean@osumc.edu. Cardiovasc Surg (Torino). 1998;39:163–165.

Journal

Journal for Vascular Ultrasound – SAGE

Published: Mar 1, 2007

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