Morphometry of Common Carotid Artery and Internal Jugular Vein in Relation to Gender and Body Side
AbstractIntroduction: The common carotid arteries originate from brachiocephalic trunk on the right and directly from the aortic arch on the left. These arteries are contained within the carotid sheaths together with the internal jugular veins and vagus nerves. The structures enclosed in carotid sheath are of great importance, since they provide most of the vascular supply of the head and neck. They exhibit a great deal of variation and are related with a number of pathologic conditions and invasive procedures. Objectives: Thus we focused on morphology of the common carotid artery (CCA) and internal jugular vein (IJV) to determine these possible variations. Methods: Neck magnetic resonance images of 81 individuals (38 females and 43 males) were evaluated retrospectively. Diameter of the lumen of the common carotid artery (CD) and the diameters of the lumen of the internal jugular vein (ID) were measured at the same level that is one slice inferior to the slice in which the bifurcation of the CCA is observed firstly. CCA intima-media thickness (CIMT), IJV intima-media thickness (IIMT), CCA-midline distance (CMD) and IJV-midline distance (IMD) were also measured at the aforementioned level. The measurements were evaluated in relation to gender and asymmetry. Results: The values measured for Right CMD, Right IMD, Left CD, Left CMD and Left IMD of males were greater than those of females (p<0.05). The results stressed various morphometric parameters and topography of the IJV and CCA. Conclusion: The results are suggested to be helpful in determination of normal values in terms of diagnostic purposes and treatment planning.
Moore, Keith L. Neck: Superficial Structures Of Neck: Cervical Regions. In: Keith L. Moore, Arthur F. Dalley, Anne M.R, Editors. Clinically Oriented Anatomy— 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2014. p. 998-1027.
Lo A, Oehley M, Bartlett A, Adams D, Blyth P, Al-Ali S. Anatomical variations of the common carotid artery bifurcation. ANZ J Surg 2006; 76: 970–2.
Koch S, Nelson D, Rundek T, Mandrekar J, Rabinstein A. Race-ethnic variation in carotid bifurcation geometry. J Stroke Cerebrovasc Dis 2009; 18: 349–53.
de Weerd M, Greving JP, de Jong AW, Buskens E, Bots ML. Prevalence of asymptomatic carotid artery stenosis according to age and sex. Stroke 2009; 40: 1105-13.
Hobson RW 2nd, Mackey WC, Ascher E, Murad MH, Calligaro KD, Comerota AJ, et al. Management of atherosclerotic carotid artery disease: clinical practice guidelines of the Society for Vascular Surgery. J Vasc Surg 2008; 48: 480–6.
Crouse JR, Goldbourt U, Evans G, Pinsky J, Sharrett AR, Sorlie P, et al. Risk factors and segment-specific carotid arterial enlargement in the Atherosclerosis Risk in Communities (ARIC) cohort. Stroke 1996; 27: 69-75.
Ruan L, Chen W, Srinivasan SR, Sun M, Wang H, Toprak A, et al.Correlates of common carotid artery lumen diameter in black and white younger adults: the Bogalusa Heart Study. Stroke 2009; 40: 702-7.
Schulz UG, Rothwell PM. Major variation in carotid bifurcation anatomy: a possible risk factor for plaque development. Stroke 2001; 32: 2522-9.
Szpinda M, Flisiński P, Wiśniewski M, Dombek M, Krakowiak-Sarnowska E. Digital-image analysis of the left common carotid artery in human foetuses. Folia Morphol (Warsz) 2008; 67: 186-92.
Syed MA, Oshinski JN, Kitchen C, Ali A, Charnigo RJ, Quyyumi AA. Variability of carotid artery measurements on 3-Tesla MRI and its impact on sample size calculation for clinical research. Int J Cardiovasc Imaging 2009; 25: 581-9.
Kröner ES, van Schinkel LD, Versluis MJ, Brouwer NJ, van den Boogaard PJ, van der Wall EE, et al. Ultrahigh-field 7-T magnetic resonance carotid vessel wall imaging: initial experience in comparison with 3-T field strength. Invest Radiol 2012; 47: 697-704.
Alizadeh DR, Doornbos J, Tamsma JT, Stuber M, Putter H, van der Geest RJ, et al. Assessment of the carotid artery by MRI at 3T: A study on reproducibility. J Magn Reson Imaging 2007; 25: 1035–43.
Weinberg SM, Scott NM, Neiswanger K, Marazita ML. Intraobserver error associated with measurements of the hand. Am J Hum Biol 2005; 17: 368-71.
Ulijaszek SJ, Lourie JA. Intra- and inter-observer error in anthropometric measurement.30-55. In: Ulijaszek SJ, Mascie-Taylor GC, Editors. Anthropometry: the Individual and the Population. Cambridge: Cambridge University Press, 1994. p. 30-55.
Goto R, Mascie-Taylor CN. Precision of measurement as a component of human variation. J Physiol Anthropol 2007; 26: 253-6.
Kemper CJ, Schwerdtfeger A. Comparing indirect methods of digit ratio (2D: 4D) measurement. Am J Hum Biol. 2009; 21: 188-91
Sadat U, Usman A, Howarth SP, Tang TY, Alam F, Graves MJ, et al. Carotid artery stiffness in patients with symptomatic carotid artery disease with contralateral asymptomatic carotid artery disease and in patients with bilateral asymptomatic carotid artery disease: a cine phase-contrast carotid MR study. J Stroke Cerebrovasc Dis 2014; 23: 743-8.
Wilbers J, Meijer FJ, Kappelle AC, Kaanders JH, Boogerd W, Dorresteijn LD, et al. Magnetic resonance imaging of the carotid artery in long-term head and neck cancer survivors treated with radiotherapy. Acta Oncol 2015; 54: 1175-80.
LaBounty TM, Hardy WD, Fan Z, Yumul R, Li D, Dharmakumar R, et al. Carotid artery thickness is associated with chronic use of highly active antiretroviral therapy in patients infected with human immunodeficiency virus: A 3.0 Tesla magnetic resonance imaging study. HIV Med 2016; 17: 516-23.
Cortés-Vicente E, Delgado-Mederos R, Bellmunt S, Borras XF, Gómez-Ansón B, Bagué S, et al. Stroke caused by a myxoma stenosing the common carotid artery. Stroke Cerebrovasc Dis 2015; 24: e87-9.
Terzi S, Arslanoğlu S, Demiray U, Eren E, Cancuri O. Carotid Doppler Ultrasound Evaluation in Patients with Pulsatile Tinnitus. Indian J Otolaryngol Head Neck Surg 2015; 67: 43–7.
Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation 2007; 115: 459-67.
Eigenbrodt ML, Bursac Z, Tracy RE, Mehta JL, Rose KM, Couper DJ. B-mode ultrasound common carotid artery intima-media thickness and external diameter: cross-sectional and longitudinal associations with carotid atherosclerosis in a large population sample. Cardiovasc Ultrasound 2008; 6: 10.
Polak JF, Sacco RL, Post WS, Vaidya D, Arnan MK, O'Leary DH. Incident stroke is associated with common carotid artery diameter and not common carotid artery intima-media thickness. Stroke 2014; 45: 1442-6.
Oishi Y, Miyoshi H, Iuchi A, Nagase N, Ara N, Oki T. Vascular aging of common carotid artery and abdominal aorta in clinically normal individuals and preclinical patients with cardiovascular risk factors: diagnostic value of two-dimensional speckle-tracking echocardiography. Heart Vessels 2013; 28: 222-8.
Crowe LA, Ariff B, Keegan J, Mohiaddin RH, Yang GZ, Hughes AD, et al. Comparison between three-dimensional volume-selective turbo spin-echo imaging and two-dimensional ultrasound for assessing carotid artery structure and function. J Magn Reson Imaging 2005; 21: 282-9.
Bos MJ, van Loon RF, Heywood L, Morse MP, van Zundert AA. Comparison of the diameter, cross-sectional area, and position of the left and right internal jugular vein and carotid artery in adults using ultrasound. J Clin Anesth 2016; 32: 65-9.
Urakov AL, Kasatkin AA, Nigmatullina AR. The dynamics of changing internal jugular veins diameter based on increasing head elevation angle. Indian J Crit Care Med 2015; 19: 610-2.
Clenaghan S, McLaughlin RE, Martyn C, McGovern S, Bowra J. Relationship between Trendelenburg tilt and internal jugular vein diameter. Emerg Med J 2005; 22: 867-8.
Yoshida H, Yaguchi S, Itaya H, Ito K, Hatanaka R, Nakai K, et al. Cannulation needle-induced anterior wall tenting of internal jugular vein causing posterior wall penetration. J Anesth 2015; 29: 467-70.
Podgórski M, Winnicka M, Polguj M, Grzelak P, Łukaszewski M, Stefańczyk L. Does the internal jugular vein affect the elasticity of the common carotid artery? Cardiovasc Ultrasound 2016; 14: 40.
Espalieu P, Cottier M, Relave M, Youvarlakis P, Cuilleret J. Radio-anatomic study of the carotid axis with regard to the implantation of microsurgical vascular anastomoses. Surg Radiol Anat 1986; 8: 257-63.
Anu VR, Pai MM, Rajalakshmi R, Latha VP, Rajanigandha V, D'Costa S. Clinically-relevant variations of the carotid arterial system. Singapore Med J 2007; 48: 566-9.
Klosek SK, Rungruang T. Topography of carotid bifurcation: considerations for neck examination. Surg Radiol Anat 2008; 30: 383-7.
Seong J, Jeong W, Smith N, Towner RA. Hemodynamic effects of long-term morphological changes in the human carotid sinus. J Biomech 2015; 48: 956-62.
Toorop RJ, Scheltinga MR, Moll FL, Bleys RL. Anatomy of the carotid sinus nerve and surgical implications in carotid sinus syndrome. J Vasc Surg 2009; 50: 177-82.
Hansen JT. Morphology of the carotid sinus wall in normotensive and spontaneously hypertensive rats. Anat Rec 1987; 218: 426-33.
Ha SM, Cho YS, Cho GC, Jo CH, Ryu JY. Modified carotid sinus massage using an ultrasonography for maximizing vagal tone: a crossover simulation study. Am J Emerg Med 2015; 33: 963-5.
Toorop RJ, Visser RF, Moll FL, Scheltinga MR. Long term safety and efficacy of internal carotid artery adventitial stripping in carotid sinus syndrome. Curr Hypertens Rev 2014; 10: 58-64.
Studinger P, Lénárd Z, Kováts Z, Kocsis L, Kollai M. Static and dynamic changes in carotid artery diameter in humans during and after strenuous exercise. J Physiol 2003; 550: 575-83.
Wang W, Chen JS, Zucker IH. Carotid sinus baroreceptor sensitivity in experimental heart failure. Circulation 1990; 81: 1959-66.
Bonchek LI, Doctor A, Rees PM. Baroreflex sensitivity and carotid sinus dimensions in dogs with coarctation. J Appl Physiol 1976; 41: 36-40.
Niebauer M, Zucker H. Static and dynamic responses of carotid sinus baroreceptors in dogs with chronic volume overload. J Physiol 1985; 369: 295–310.
Hauswald M, Tandberg D. The effect of patient position and MAST inflation on carotid sinus diameter. Ann Emerg Med 1985; 14: 1065-8.
Li F, Wang X. Bilateral symmetry of human carotid artery atherosclerosis: a multi-contrast weighted MR study. Int J Cardiovasc Imaging 2016; 32: 1219-26.
Adams GJ, Simoni DM, Bordelon CB Jr, Vick GW 3rd, Kimball KT, Insull W Jr, et al. Bilateral symmetry of human carotid artery atherosclerosis. Stroke 2002; 33: 2575-80.
Benetos G, Toutouzas K, Drakopoulou M, Tolis E, Masoura C, Nikolaou C, et al. Bilateral symmetry of local inflammatory activation in human carotid atherosclerotic plaques. Hellenic J Cardiol 2015; 56: 118-24.
Oppenheimer AG, Fulmer S, Shifteh K, Chang JK, Brook A, Shanske AL, et al. Cervical vascular and upper airway asymmetry in Velo-cardio-facial syndrome: correlation of nasopharyngoscopy with MRA. Int J Pediatr Otorhinolaryngol 2010; 74: 619-25.
Thies R. Cardiovascular Physiology. In: Thies R Editors. Physiology. Oklahoma: Oklahoma Notes, 1995. p.75-122.
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