Common carotid artery surprise during percutaneous dilatational tracheostomy-a near miss, confirmed with ultrasound

The practice of percutaneous dilatational tracheostomy [PDT] has gained popularity and acceptance due to the ease in acquiring its skill and low probability of complications. Nevertheless, PDT is associated with a few complications, some really life-threatening. We present a case of an abnormally located common carotid artery encountered during PDT in our intensive care unit. The procedure was electively posted, in an old patient chronically ventilated after a revived cardiac arrest. While identifying the landmarks on palpation pulsation was felt similar to arterial pulsation. This was confirmed using bedside portable ultrasonography and found to be the right common carotid artery forming a loop anterior to the trachea at the level of the third and fourth tracheal rings. The patient had a past history of thyroidectomy and this was suspected to be the primary reason for the altered course of the right common carotid artery

Two Cases of Aberrant Right Subclavian Artery and Right Vertebral Artery that Originated from the Right Common Carotid Artery

We present here two patients that had an aberrant right subclavian artery and an anomalous origin of the right vertebral artery from the right common carotid artery. We review the previous literature and discuss herein the embryologic mechanism and clinical implications of this variation.

Arteria trigeminal persistente asociada a aneurisma de carótida intracavernosa: comunicación de un caso / Persistent primitive trigeminal artery with cavernous carotid aneurysm (Case report)

Se presenta el caso de una paciente que asociada a una arteria trigeminal persistente presentó un aneurisma de gran tamaño en la carótida intracavernosa ipsilateral. Es estudiada con resonancia magnética y resonancia magnética angiográfica. Revisamos la clasificación angiográfica de Saltzamn y la frecuente asociación a malformaciones vasculares

Left costocervical vein malformation with anomalous ramification of aortic arch in a dog

This report describes coexistence of anomalous branches of the aortic arch and the costocervical vein malformation in a German shepherd dog. The first branch of the aortic arch was a bicarotid trunk that divided into the left and right common carotid arteries. The next branch to leave the aortic arch was a common trunk for the right and left subclavian arteries, a bisubclavian trunk, which was immediately bifurcated. The right subclavian artery passed over the esophagus forming a deep groove, so-called incomplete vascular ring on the dorsal wall of the esophagus. Although the esophagus was constricted by the right subclavian artery dorsally and by the trachea ventrally, no clinical symptoms of esophageal obstruction and dysphagia were observed. The left costocervical vein coursed caudoventrally, passed over the aortic arch, and entered the left ventricle. This vessel was much smaller than the right costocervical vein and was partially occluded at its origin.

Sindrome de Eagle - Variante estilo - Carotideo: presentación de un caso clínico / Eagle syndrome - Style variant - Carotid: report of a clinical case

The objective of this publication is the description of a clinical case of long evolution that presented the following symptoms: dizziness and transient syncope, and in occasions, it anguishes and sensation of imminent death. The same one was diagnosed as Syndrome of Eagle. It is important to clarify that this pathology presents different clinical variants, belonging one to them those related with the artery carotid what would explain the sensation of eminent death.