Surgical anatomy of the cervical carotid artery for carotid endarterectomy
Surgical anatomy of the cervical carotid artery for carotid endarterectomy
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DOI：
10.2176/nmc.45.25
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发表时间：
2005-01-01
影响因子：
1.9
通讯作者：
Endo, S
中科院分区：
文献类型：
--
作者：
Hayashi, N;Hori, E;Endo, S
颈动脉内膜剥脱术（CEA）是治疗颈内动脉粥样硬化斑块的主要方法。对49具尸体颈动脉三角区的颈动脉进行了外科解剖学研究。颈动脉分叉位于C-3下1/3水平。上级甲状腺动脉70%起自颈外动脉前壁，30%起自颈总动脉远端。舌动脉在上级甲状腺动脉和面动脉之间单独分支的占81%，面动脉与上级甲状腺动脉共分支的占18%，舌动脉与面动脉共分支的占1%。枕动脉起源于颈外动脉后部，57%的标本位于面动脉起点以上，32%的标本位于面动脉和舌动脉起点之间，11%的标本位于舌动脉起点以下。枕动脉起点位置较低，舌下神经与枕动脉远段交叉者占20%。咽升动脉起源于颈外动脉后壁舌动脉起点以上者占66%，舌动脉起点以下者占9%，枕动脉近端部者占19%，颈动脉分叉部者占2%，颈内动脉者占2%。颈外动脉的分支是充分暴露和在颈动脉上适当放置交叉夹的关键标志。了解颈动脉的外科解剖是在无血手术视野中成功清除斑块和减少术后并发症的必要条件。
Carotid endarterectomy (CEA) is the main treatment for atherosclerotic plaque of the cervical internal carotid artery. The surgical anatomy of the carotid arteries was studied in the carotid triangle of 49 cadavers. The carotid bifurcation was located at the level of the lower third of C-3. The superior thyroid artery arose from the anterior wall of the external carotid artery in 70% of specimens and from the distal portion of the common carotid artery in 30%. The lingual artery arose as a separate trunk between the origins of the superior thyroid and facial arteries in 81% of specimens, with the facial artery from a common trunk in 18%, and with the superior thyroid artery in 1%. The occipital artery arose from the posterior aspect of the external carotid artery above the level of origin of the facial artery in 57% of specimens, between the origins of the facial and lingual arteries in 32%, and below the origin of the lingual artery in 11%. The origin of the occipital artery was positioned low and the distal portion of the occipital artery was crossed by the hypoglossal nerve in 20%. The ascending pharyngeal artery arose from the posterior wall of the external carotid artery above the level of origin of the lingual artery in 66% of specimens, below the origin of the lingual artery in 9%, from the proximal portion of the occipital artery in 19%, from the carotid bifurcation in 2%, and from the internal carotid artery in 2%. The branches of the external carotid artery are the key landmarks for adequate exposure and appropriate placement of cross-clamps on the carotid arteries. It is necessary to understand the surgical anatomy of the carotid arteries to carry out successful removal of plaque and minimize postoperative complications in a bloodless surgical field.