• Title/Summary/Keyword: Carotid Bifurcation

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An Anatomical Variant : Low-Lying Bifurcation of the Common Carotid Artery, and Its Surgical Implications in Anterior Cervical Discectomy

  • Gulsen, Salih;Caner, Hakan;Altinors, Nur
    • Journal of Korean Neurosurgical Society
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    • v.45 no.1
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    • pp.32-34
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    • 2009
  • The common carotid artery generally bifurcates into the internal and external carotid arteries at the level of C3-4. Injury to the common carotid artery during anterior cervical discectomy is a complication that is very much feared but encountered rarely. Knowing the anatomic variations of the common carotid artery and using an operating microscope during the anterior cervical approach for cases with low-lying bifurcation of the common carotid artery would prevent injuries to this artery. We present a 42-year-old female who has successfully undergone anterior cervical discectomy at the level of C5-6 and C6-7. She had a low-lying bifurcation of the common carotid artery.

NUMERICAL ANALYSIS OF BLOOD FLOW DYNAMICS AND WALL MECHANICS IN A COMPLIANT CAROTID BIFURCATION MODEL (혈관 유연성을 고려한 경동맥 분기부 모델 혈류역학 해석)

  • Nguyen, T.M.;Lee, S.W.
    • 한국전산유체공학회:학술대회논문집
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    • 2011.05a
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    • pp.500-503
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    • 2011
  • Blood flow simulations in an idealized carotid bifurcation model with considering wall compliance were carried out to investigate the effect of wall elasticity on the wall shear stress and wall solid stress. Canonical waveforms of flowrates and pressure in the carotid arteries were imposed for the boundary conditions. Comparing to rigid wall model, generally, we could find an increased recirculation region at the carotid bulb and an overall reduced wall shear stress. Also, there was appreciable change of flowrate and pressure waveform in longitudinal direction. Solid and wall shear stress concentration occurs at the bifurcation apex.

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Numerical Study on Blood Flow Dynamics and Wall Mechanics in a Compliant Carotid Bifurcation Model (혈관 유연성을 고려한 경동맥 분기부 모델 혈류역학 해석)

  • Nguyen, Minh Tuan;Lee, Sang-Wook
    • Journal of the Korean Society of Visualization
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    • v.13 no.2
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    • pp.28-32
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    • 2015
  • Blood flow simulations in an realistic carotid bifurcation model with considering wall compliance were carried out to investigate the effect of wall elasticity on the wall shear stress and wall solid stress. Canonical waveforms of flow rates and pressure in carotid arteries were imposed for boundary conditions. Compared to a rigid wall model, we found an increased recirculation region at the carotid bulb and an overall reduction of wall shear stress in a compliant model. Additionally, there was appreciable change of flow rate and pressure wave in longitudinal direction. Both solid and wall shear stress concentration occur at the bifurcation apex.

THE RELATIVE IMPORTANCE OF NON-NEWTONIAN CHARACTERISTICS OF BLOOD IN THE HEMODYNAMICS OF THE CAROTID BIFURCATION (경동맥 혈류유동에서의 혈액의 비뉴우토니안 특성의 상대적 중요성 해석)

  • Lee, S.W.;Steinman, D.A.
    • 한국전산유체공학회:학술대회논문집
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    • 2008.03a
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    • pp.181-185
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    • 2008
  • In this study, we attempted to quantify the relative importance of assumptions regarding blood rheology. Three patient-specific carotid bifurcation geometries and time-varying flow rates were obtained using magnetic resonance imaging. For each subject, CFD simulations were carried out assuming two different non-Newtonian rheology models Carreau and Ballyk models) and rescaled Newtonian viscosities based on characteristic shear rates to account for the shear-thinning property of blood. The sensitivity of WSS and oscillatory shear index (OSI) were contextualized with respect to the reproducibility of the reconstructed geometry and to assumptions regarding the inlet boundary conditions. We conclude that the assumption of Newtonian fluid is reasonable for studies aimed at quantifying the distribution of WSS-based extrema in an image-based CFD model of carotid bifurcation.

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THE RELATIVE IMPORTANCE OF NON-NEWTONIAN CHARACTERISTICS OF BLOOD IN THE HEMODYNAMICS OF THE CAROTID BIFURCATION (경동맥 혈류유동에서의 혈액의 비뉴우토니안 특성의 상대적 중요성 해석)

  • Lee, S.W.;Steinman, D.A.
    • 한국전산유체공학회:학술대회논문집
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    • 2008.10a
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    • pp.181-185
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    • 2008
  • In this study, we attempted to quantify the relative importance of assumptions regarding blood rheology. Three patient-specific carotid bifurcation geometries and time-varying flow rates were obtained using magnetic resonance imaging. For each subject, CFD simulations were carried out assuming two different non-Newtonian rheology models (Carreau and Ballyk models) and rescaled Newtonian viscosities based on characteristic shear rates to account for the shear-thinning property of blood. The sensitivity of WSS and oscillatory shear index (OSI) were contextualized with respect to the reproducibility of the reconstructed geometry and to assumptions regarding the inlet boundary conditions. We conclude that the assumption of Newtonian fluid is reasonable for studies aimed at quantifying the distribution of WSS-based extrema in an image-based CFD model of carotid bifurcation.

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A cadaveric study on variations in branching pattern of external carotid artery

  • Devadas, Deepa;Pillay, Minnie;Sukumaran, Tintu Thottiyil
    • Anatomy and Cell Biology
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    • v.51 no.4
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    • pp.225-231
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    • 2018
  • Variations in the vascular anatomy of the carotid triangle have been reported in current scientific literature. The carotid arteries, being the major feeding arteries of the head and neck deserve special importance and protection from iatrogenic injury during radiological evaluations and surgical interventions. The present study was carried out over a period of 4 years from 2012-2016 to assess the variant anatomy of external carotid artery. The external carotid artery and its branches were dissected bilaterally in 40 formalin embalmed cadavers. The external carotid artery was traced from its origin to termination and variations in the branching pattern as well as the level of the carotid bifurcation were observed and analysed. A higher carotid bifurcation was observed in 25% cases. The linguofacial trunk was the commonest variation noted in the branching pattern seen in 20% cases. A single case of unilateral thyrolinguofacial trunk was also observed. The external carotid artery gave rise to accessory branches in 7.5% cases namely the superior laryngeal, accessory ascending pharyngeal and masseteric branches. A slender branch to the internal jugular vein was also observed in one case. These findings may provide further insight into the understanding of the vascular anatomy of the carotid triangle to the curious student, the discerning radiologist and the vigilant surgeon to avert complications and help improve overall treatment outcome.

Management of Carotid Body Paraganglioma: Review of the literature with report of three cases (경동맥체 부신경절종)

  • Park Cheong-Soo;Kim Jun-Sik;Hong Won-Pyo;Choi Eun-Chang;Kim Dong-Ik
    • Korean Journal of Head & Neck Oncology
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    • v.5 no.1
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    • pp.5-13
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    • 1989
  • Carotid body paraganglioma is uncommon, with appoximately 900 reports of it in the world literature, and with only 7 documented cases in the Korean literature. The classic carotid body paraganglioma develops in the bifurcation of common carotid artery and involves both the internal and external carotid arteries at it expands. The diagnosis may almost always be established preoperatively by selective angiography which shows a widening of the carotid bifurcation with a well defined vascular mass. Differential consideration of a single, lateral cervical mass in this location include branchial cleft cyst, neurogenic tumor, metastatic thyroid cancer, carotid body aneurysm and salivary gland tumor. Surgical therapy is the preferred method of treatment as these tumors are regarded as radioresistant. Because of their high vascularity and anatomical location, surgical removal of these tumors reguires a considerable degree of caution and a high degree of surgical expertise. With improved diagnostic and surgical technique, the morbidity and mortality has been reduced lately. This report details the management of 3 patients with carotid body paraganglioma who underwent safe resection by subadventitial dissection or using an internal vascular shunt.

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Computer Simulation and MRA Observation for Steady Flow in the Carotid Arterial Bifurcation (경동맥 분지관내 정상유동에 대한 컴퓨터 시뮬레이션과 MRA 관찰)

  • Suh, S.H.;Cho, M.T.;Yoo, S.S.;Chung, T.S.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.05
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    • pp.73-76
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    • 1996
  • Computer simulation and magnetic resonance angiograms(MRAs) are used to understand for flow patterns in the carotid arterial bifurcation. Steady momentum equation is solved by the finite volume method. A Phantom of the carotid artery made of bioacrylic material is used for MRA observation. Flow Patterns are observed by using MRA for flow in the phantom of an automatic closed-type circulatory system filled with sugar 4 w% solution. For numerical analysis the idealized geometric shape of the carotid artery is constructed to portray the phantom. Results of numerical analysis are compared with those of MRA. The flow patterns of the phantom on MRA are almost identical to those of the computer simulation.

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Influence of Inlet Secondary Curvature on Hemodynamics in Subject-Specific Model of Carotid Bifurcations (환자 특정 경동맥 분기부 모델 혈류유동에 대한 입구부 이차곡률의 영향)

  • Lee, Sang-Wook
    • Journal of the Korean Society for Nondestructive Testing
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    • v.31 no.5
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    • pp.479-486
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    • 2011
  • In image-based CFD modeling of carotid bifurcation hemodynamics, it is often not possible (or at least not convenient) to impose measured velocity profiles at the common carotid artery inlet. Instead, fully-developed velocity profiles are usually imposed based on measured flow rates. However, some studies reported a pronounced influence of inflow boundary conditions that were based on actual velocity profiles measured by magnetic resonance imaging which showing the unusual presence of a high velocity band in the middle of the vessel during early diastole inconsistent with a Dean-type velocity profile. We demonstrated that those velocity profiles were induced by the presence of modest secondary curvature of the inlet and set about to test whether such more "realistic" velocity profiles might indeed have a more pronounced influence on the carotid bifurcation hemodynamics. We found that inlet boundary condition with axisymmetric fully-developed velocity profile(Womersley flow) is reasonable as long as sufficient CCA inlet length of realistic geometry is applied.

carotid Body Paragangrioma -Two cases report- (경동맥체 부신경절종 -수술치험 2례-)

  • 박영훈;김욱진
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.1023-1027
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    • 1996
  • The carotid body is derived from both mesoderm and elements of the third branchial arch and neural crest ectoderm. It is located within the advaptitial layer of the posteromedial aspe t of the common carotid bifurcation. Tumors arising from this body were originally termed chemodectomas, but they actually arise from the paraganglionic cells and thereby should be classified as paragangliomas. Carotid body. tumors present as a painless, palpable mass over the carotid bifurcation region of the neck. The definitive study for diagnosis of carotid body tumors is selective bilateral cerebral arteriography. Current treatment of ca- rotid body tumors is primarily operative excision of the tumor with maintenance of the Integrity of carotid flow. Recently, the authors experienced two cases of carotid body tumor which were successfully treated by surgical excision. We report these cases with brief review of the literature.

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