Superior Tiroidal Arterin Ana Karotis Arterden Köken Aldığı Hastada Başarılı Karotis Endarterektomi

Abstract

Ana karotis arter eksternal ve internal ayırımından önce dal vermez. Anatomik varyasyonları nadirdir ve çoğu zaman postmortem anatomi çalışmalarında rastlantısal olarak görülmektedir. Bu varyasyonlardan biri de genelikle eksternal karotis arterden ayrılan superior tiroid arter (STA)’in ana karotis arterden köken almasıdır. Biz bu yazımızda karotis arter hastalığı nedeniyle operasyona alınan ve ana karotis arterden ayrılan STA varyasyonu olan hastada yapılan karotis endarterektomiyi sunmaktayız. Serebrovasküler olay öyküsü olan 55 yaşında erkek hastada yapılan karotis Doppler ultrasonografi ve karotis-vertebral anjiyografisinde sol internal karotis arterde stenoz saptanması üzerine hastaya operasyon planlandı. Sol karotis endarterektomi için yapılan boyun diseksiyonunda ana karotis arterden köken alan variant STA görüldü. Klasik yöntemle başarılı bir şekilde sol karotis endarterektomi yapıldı. Literatüre bakıldığında STA’nın köken aldığı bölge ile karotis arterin bifurkasyonunun seviyesi arasında bir ilişki olduğu görülmektedir. Yüksek seviyeli karotis arter bifurkasyonu olan hastalarda STA ana karotis arterden köken alma eğilimindedir. Karotis endarterektomide internal karotis artere erişim önemli basamaklardan biridir. Bu nedenle ana karotis arterden köken alan STA varlığı cerrahi erişimin zorluğunda öngörü sağlayabilir.

Keywords

• Superior tiroid arter,ana karotis arter,karotis endarterektomi

Successful Carotid Endarterectomy in a Patient with Superior Thyroid Artery Originated from Common Carotid Artery

Abstract

The common carotid artery typically does not have any branches in the neck before it bifurcates into the external and internal carotid arteries. Anomalies of the common carotid artery are rare and are usually incidental findings in postmortem anatomical dissection. One of these anomalies is the superior thyroid artery (STA), which occasionally originates from external carotid artery, arising from the common carotid artery. In this article, we present a successful carotid endarterectomy in a patient with an aberrant branch from the common carotid artery. Because carotid and vertebral artery Doppler ultrasonography and angiography showed subtotal occlusion at the left internal carotid artery, carotid endarterectomy was planned. When the left carotid artery was explored, the left STA was found arising from the common carotid artery. Traditional carotid endarterectomy was successfully performed. There is a relation between the origin of the STA and the site of bifurcation of the carotid artery in the literature. The STA tends to arise from the common carotid artery in the patients with high carotid bifurcation. Access to the internal carotid artery is an important step of carotid endarterectomy. Therefore, the finding of the STA originating from the common carotid artery can provide an insight on difficulties with surgical access.

Keywords

• Superior thyroid artery,common carotid artery,carotid endarterectomy

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