open access

Vol 77, No 4 (2018)
Original article
Submitted: 2017-10-23
Accepted: 2018-02-11
Published online: 2018-02-20
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Variations in carotid sinus anatomy and their relevance to carotid interventions

C. T. West1, C. Brassett1, M. E. Gaunt1
·
Pubmed: 29500893
·
Folia Morphol 2018;77(4):693-697.
Affiliations
  1. University of Cambridge

open access

Vol 77, No 4 (2018)
ORIGINAL ARTICLES
Submitted: 2017-10-23
Accepted: 2018-02-11
Published online: 2018-02-20

Abstract

Background: The carotid sinus (CS) is a dilatation in the carotid bifurcation usually at the origin of proximal internal carotid artery (ICA). It contains baroreceptors which influence blood pressure. Variations in the location of the CS are of importance as atheromatous plaque commonly forms in this area and procedures such as carotid endarterectomy are performed to reduce the risk of stroke. Inadvertent stimulation of the CS baroreceptors during interventions can have profound effects on the patient’s haemodynamic status both intra- and postoperatively, causing serious complications. The aim of this study is to determine the inter- and intra-individual variations in the location of the CS.

Materials and methods: Eighty-two carotid arteries were dissected bilaterally from 41 cadavers. The locations of the CS were noted and divided into four potential sites.


Results: The commonest site is the origin of the ICA (74.3%), but the CS can also be found in the distal part of the common carotid artery (CCA) inferior to the bifurcation (17.1%); at the bifurcation involving the distal CCA and origins of both the external carotid artery (ECA) and ICA (7.32%); and at the origin of the ECA (1.22%). In individual cadavers, the CS was located at the origin of the ICA in 97.6% on at least one side. The sites of the CS were asymmetrical in 34.1%.

Conclusions: Clinicians performing carotid interventions should be aware of these anatomical variations to avoid inadvertent stimulation of the CS which can cause profound bradycardia and hypotension.

Abstract

Background: The carotid sinus (CS) is a dilatation in the carotid bifurcation usually at the origin of proximal internal carotid artery (ICA). It contains baroreceptors which influence blood pressure. Variations in the location of the CS are of importance as atheromatous plaque commonly forms in this area and procedures such as carotid endarterectomy are performed to reduce the risk of stroke. Inadvertent stimulation of the CS baroreceptors during interventions can have profound effects on the patient’s haemodynamic status both intra- and postoperatively, causing serious complications. The aim of this study is to determine the inter- and intra-individual variations in the location of the CS.

Materials and methods: Eighty-two carotid arteries were dissected bilaterally from 41 cadavers. The locations of the CS were noted and divided into four potential sites.


Results: The commonest site is the origin of the ICA (74.3%), but the CS can also be found in the distal part of the common carotid artery (CCA) inferior to the bifurcation (17.1%); at the bifurcation involving the distal CCA and origins of both the external carotid artery (ECA) and ICA (7.32%); and at the origin of the ECA (1.22%). In individual cadavers, the CS was located at the origin of the ICA in 97.6% on at least one side. The sites of the CS were asymmetrical in 34.1%.

Conclusions: Clinicians performing carotid interventions should be aware of these anatomical variations to avoid inadvertent stimulation of the CS which can cause profound bradycardia and hypotension.

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Keywords

carotid sinus, carotid endarterectomy, common carotid artery, internal carotid artery, external carotid artery

About this article
Title

Variations in carotid sinus anatomy and their relevance to carotid interventions

Journal

Folia Morphologica

Issue

Vol 77, No 4 (2018)

Article type

Original article

Pages

693-697

Published online

2018-02-20

Page views

3831

Article views/downloads

1951

DOI

10.5603/FM.a2018.0017

Pubmed

29500893

Bibliographic record

Folia Morphol 2018;77(4):693-697.

Keywords

carotid sinus
carotid endarterectomy
common carotid artery
internal carotid artery
external carotid artery

Authors

C. T. West
C. Brassett
M. E. Gaunt

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