Occlusions of the Carotid Arteries

Abstract

The branching point of the common carotid artery, the carotid bifurcation, may be found at different levels, anywhere between C2 and C5/C6. It is most commonly found at the level of C4, (Fig. 18.1.1). The level of the carotid bifurcation has an influence on the angle between the two arteries originating at this point: a caudal division leads to an acute angle and a more cranial division to a more archlike bifurcation [18]. The internal carotid artery usually lies on the lateral side and in 8% of cases on the medial side. A medial location may make exposure of this artery difficult. The carotid arteries are almost always very straight and tightly stretched as they run up through the neck. However, sometimes they may show marked elongation, especially the internal carotid artery. There are congenital elongations, which are found in children, and acquired elongations due to arteriosclerotic lesions. Elongations are more often found in eldery patients, and may be C- or S-shaped with or without a kinking stenosis.