Anatomical Variations of Carotid Arteries

The carotid arterial system exhibits a remarkable spectrum of anatomical variants that bear direct relevance to cerebrovascular health, surgical planning and endovascular interventions. Variations may involve the level of bifurcation of the common carotid artery, differing origins or courses of the internal and external carotid arteries, persistence of embryonic anastomoses and morphological changes such as tortuosity, coiling or kinking. Such deviations from the “classic” anatomy can influence haemodynamic patterns, predispose to atherosclerotic plaque formation or complicate procedures including carotid endarterectomy, stenting and neck dissection. Recognition of high or low bifurcation, fenestrations and rare connections (for example persistent hypoglossal or proatlantal intersegmental arteries) is essential for accurate interpretation of angiographic studies and safe operative exposure. Recent advances in high-resolution imaging and three-dimensional reconstruction have deepened our understanding of variant prevalence across different populations and their implications for stroke risk, while cadaveric dissections continue to refine the topographical relationships important in head and neck surgery.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Anatomical Variations of Carotid Arteries publication trend

The graph below shows the total number of articles in anatomical variations of carotid arteries across all publications each year (not limited to Nature Index journals).

Technical terms

Common carotid artery: The principal vessel supplying blood to the head and neck, dividing into internal and external branches at the bifurcation.

Internal carotid artery: The branch of the common carotid that supplies intracranial structures, notably the anterior cerebral circulation.

External carotid artery: The branch of the common carotid that provides arterial blood to facial, scalp and neck tissues via multiple branches.

Bifurcation level: The anatomical height at which the common carotid artery divides, which can vary from the body of C2 to C5 vertebral levels.

Tortuosity, coiling, kinking: Descriptors of abnormal arterial configuration in which the vessel follows an excessive curve (tortuosity), loops on itself (coiling) or forms an acute bend (kinking).

Fenestration: A segment of an artery that splits into two parallel channels before reuniting, forming a window-like appearance on imaging.

Axial spin: The rotational orientation of the internal versus external carotid arteries around their common axis at the bifurcation, classified by relative antero-posterior and medial-lateral positions.

References

1. The Axial Spin of the Carotid Bifurcation. Diagnostics (2023).