Hemodynamic changes in the head and neck after ligation of the unilateral carotid arteries: a study using color Doppler imaging
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Y Takeuchi1, T Numata, A Konno
1Department of Otorhinolaryngology, Chiba University School of Medicine, Japan.
Insights
The study identified key collateral pathways for the external carotid artery (ECA) region. The occipital artery and contralateral carotid artery are crucial for maintaining blood flow during carotid artery ligation.
Area of Science:
- Vascular Surgery
- Cerebrovascular Hemodynamics
- Medical Imaging
Background:
- Collateral circulation is vital for maintaining blood flow to the brain and head regions during carotid artery interventions.
- Understanding these pathways is crucial for surgical planning and preventing ischemic complications.
Purpose of the Study:
- To evaluate the hemodynamics of collateral circulation to the ligated external carotid artery (ECA) region.
- To identify the primary collateral pathways during unilateral carotid artery ligation and resection.
Main Methods:
- Color Doppler imaging and angiography were used to measure blood flow direction and volume in ECA branches.
- Digital suppression of the common carotid artery (CCA) was performed on both ligated and nonligated sides.
Main Results:
- In unilateral ECA ligation, the ipsilateral occipital artery via Richter's anastomosis from the vertebral artery was the main collateral pathway.
- In cases of CCA, ECA, and internal carotid artery resection, the contralateral carotid artery served as the primary collateral pathway.
- Superior and inferior labial arteries were significant collateral pathways originating from the contralateral ECA.
Conclusions:
- The study elucidates the primary collateral pathways supplying the ECA region under different carotid artery ligation and resection scenarios.
- Findings highlight the importance of the occipital artery and contralateral carotid artery in collateral compensation.
- The superior and inferior labial arteries play a notable role in collateral supply from the contralateral ECA.
Abstract:
For evaluation of the hemodynamics of the collateral circulation to the ligated external carotid artery (ECA) region, we measured the blood flow direction and volume in branches of the ECA in patients with unilateral carotid artery ligation before and during digital suppression of the common carotid artery (CCA) on the ligated and nonligated sides with color Doppler imaging and angiography. The main collateral pathway to the ligated ECA region was the ipsilateral occipital artery through Richter's anastomosis from the vertebral artery in the case of unilateral ECA ligation, and was the contralateral carotid artery in the case of unilateral CCA, ECA, and internal carotid artery resection. The superior and inferior labial arteries were important as the collateral pathway from the contralateral ECA.