Variation in the course of the common carotid artery and its branches as predisposing factors for stroke

Considering the tremendous role of the carotid artery system for the nourishment of the brain, sensory organs and other morphological structures of the head and neck, knowledge about variation in the course of the carotid arteries is of high clinical significance. Thus, the aim of our study was to determine the variations in the course of the common carotid artery (CCA) and of its main branches, emphasizing the most susceptible variants for stroke development.

A retrospective study on 210 computed tomography angiographs of 118 males and 92 females, with a mean age of 64.2 ± 13.82 years was carried out. The RadiAnt DICOM Viewer 2024.1 software for three-dimensional reconstruction, visualization and morphometry of the CCAs was used. For the statistical analysis predefined EXCEL functions were applied.

In 25.23% the CCA originated from the bovine arch and in 0.95% from the bicarotid trunk. Variations in the course of the CCA and its main branches were represented by tortuosity (37.61%); kinking (34.28%); coiling (0.95%); "kissing" (2.38%). Passage under the hyoid bone of CCA was registered in 2.38%; of the internal carotid artery (ICA) - in 1.42% and of the external carotid artery (ECA) - in 2.38%.

In 1/4 of the cases, the CCA derived from the bovine arch. The most common variations in the carotid arteries course were tortuosity and kinking, followed by "kissing" and coiling. A course under the hyoid bone was established for each carotid artery. All the revealed variants of the carotid arteries course are significant in terms of risk for stroke development, nevertheless, in kinking with sharp angulations the rick is higher.