title: Bovine Aortic Arch and Bilateral Retroesophageal Course of Common Carotid Arteries in a Symptomatic Patient.
abstract: Anatomical variations of carotid arteries may be related to their development (agenesis, aplasia, hypoplasia) or course (coiling, kinking, tortuosity). Partial or total aberrancies in carotid vessel anatomy rarely occur. We describe the case of a 95-year-old woman presented with sudden onset of confusion and disorientation together with upper limb clonus. Computed tomography (CT)-scan revealed a left frontal brain injury with a not conclusive carotid doppler ultrasound. CT angiography reported a bovine aortic arch with bilateral retroesophageal course of both common carotid arteries and left severe (>70%) internal carotid artery stenosis. The knowledge of anatomical variations of the course of carotid arteries is relevant for possible surgical or endovascular repair or in case of otolaryngology or intubation procedures.
authors.affiliation: Department of Vascular Surgery, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Bissacco
authors.affiliation: Department of Vascular Surgery, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Domanin
authors.affiliation: Department of Geriatric Medicine and Gerontology, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Schinco
authors.affiliation: Department of Vascular Surgery, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Livio
authors.initials: L
authors.lastname: Gabrielli
keywords: Cardiovascular abnormalities; Carotid arteries; Carotid stenosis; Tomography; x-ray computed