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Anatomy - Percutaneous transluminal angioplasty and stenting of the right internal carotid artery in recurrent stenosis– Vascular surgery

vascular surgery
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  1. Common carotid artery

    Common carotid artery
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    Origin

    • Left: aortic arch
    • Right: brachiocephalic trunk

    Course

    • Ascends posterior to the sternocleidomastoid muscle
    • Within the carotid sheath

    Division

    • Carotid bifurcation: divides into internal and external carotid artery

    Arterial blood supply for

    1. Internal carotid artery

    • Brain
    • Eye
    • Forehead
    • Anterior nasal cavity

    2. External carotid artery

    • Extracranial structures of the head and neck

  2. Internal carotid artery

    Origin

    • Branch of the common carotid artery (carotid bifurcation)

    Caudocephalad course

    1. Cervical part

    • Segment between origin of common carotid artery and base of skull
    • Enters the skull via the carotid canal
    • Does not give rise to any branches

    2. Petrous part

    • Courses in the petrous portion of the temporal bone
    • Minor branches to the tympanic cavity and pterygoid canal

    3. Cerebral part

    • Courses in the subarachnoid space
    • Passes through the dura mater
    • Divides into anterior and middle cerebral artery
    • Anterior cerebral artery communicates via the anterior communicating artery with the contralateral anterior cerebral artery

    The arterial vascular ring at the base of the brain supplying it with blood is known as the cerebral arterial circle (of Willis). From anterior to posterior, it comprises the following vessels:

    • Anterior communicating artery (unpaired)
    • Anterior cerebral artery (left and right)
    • Internal carotid artery (left and right) and its direct continuation, the middle cerebral artery
    • Posterior communicating artery (left and right)
    • Posterior cerebral artery (left and right, both arising from the basilar artery).

    However, the circle of Willis has numerous variations both in branch caliber and anastomoses (hypoplasia of individual branches or even agenesis of subsegments). This is clinically relevant for collateral blood supply in stenosis.

External carotid artery

The areas supplied by the external carotid artery can be divided into four groups depending on thei

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