Common carotid artery

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Right carotid artery from Gray's Anatomy (1918)
Carotids (red) in the area behind the jugular veins (blue)

The carotid ( lat. Transliteration of Greek [ἀρτηρία] καρωτίς carotid , of καρόω "Be moved into a deep sleep," see. Καρώδης karōdēs "stunned" - the symptom of pressure on these arteries ; plural: carotid arteries ), or all of the carotid artery communis , is the common carotid artery . Because of its course in the neck, it is often referred to as the carotid artery . It runs in the depths of the so-called throttle groove , esophagus and trachea from the chest entrance to the head. Your pulse can easily be felt in the neck area .

Course and branch

In humans, it arises as a strong vessel on the right side from the brachiocephalic trunk , while on the left it usually arises directly from the aortic arch . In the neck area it runs with other conduction structures in the vagina carotica . In mammals (including humans) it is finally divided in the "carotid fork" into:

The height of the "carotid fork" varies greatly from person to person. When projected onto the cervical spine, it can vary between the second and sixth cervical vertebrae, in the majority of cases it is at the level of the fourth cervical vertebra.

At the outlet of the internal carotid artery, the carotid sinus , there are pressure receptors (also called presso or baroreceptors ) that monitor blood pressure in the arterial system and transmit the information to the cardiovascular center in the brain and represent the receptor area for the carotid sinus reflex . In addition, the internal carotid artery can be found at the origin chemoreceptors in the so-called carotid body that the content of carbon dioxide , oxygen and pH in blood monitor.

Diseases

Stenosis in the common carotid artery on ultrasound; the speed of blood flow is increased in the area of ​​the stenosis.

Common disease of the carotid artery is an arteriosclerosis -related vasoconstriction (stenosis). For hemodynamic reasons, this is in the majority of cases in the area of ​​the carotid bifurcation, i.e. in the area of ​​the division into the internal carotid artery and external carotid artery. Risk factors include tobacco smoking , hypercholesterolemia , high blood pressure, and male gender. This disease increases the risk of a stroke, so that an operation ( thrombendarterectomy ) or a stent angioplasty can be performed here if the severity is appropriate . The rule here is that, in contrast to endarterectomy, there are no long-term results for stent angioplasty . However, a large-scale randomized US American clinical study (the CREST study), which was carried out on over 2500 patients, shows the equivalence of both methods over a period of four years after randomization : both surgical cleaning of the common carotid artery and the implantation of a stent proved to be equally safe and effective methods for the treatment of vasoconstriction. Other (European) studies (ICSS, EVA-3S and SPACE), on the other hand, indicate that carotid endarterectomy is superior to stent-protected angioplasty, as strokes in particular were less common here . The risk of performing stent angioplasty on the carotid gland is higher compared to surgery, especially in patients older than 75 years - this group of patients is most often affected by vasoconstriction - as is the rate of recurrence . However, according to some experts, the superiority of carotid endarterectomy observed in the latter studies appears primarily to be due to the inexperience of many (European) vascular surgeons with regard to the use of stent angioplasty. On the other hand, assuming the application of rigorous operational standards and protocols, both methods seem to lead to comparable results.

Splitting of the vascular wall layers ( dissection , carotid dissection ) also leads to circulatory disorders and other neurological symptoms.

A pathologically increased carotid sinus reflex is called carotid sinus syndrome .

See also

Web links

Wiktionary: carotid artery  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ↑ FCAT - Federative Committee on Anatomical Terminology: Terminologia Anatomica. Thieme, Stuttgart et al. 1998, ISBN 3-13-114361-4 .
  2. ^ Thomas G. Brott et al .: Stenting versus Endarterectomy for Treatment of Carotid-Artery Stenosis. In: The New England Journal of Medicine. Vol. 363, No. 1, 2010, pp. 11-23, PMID 2932446 , doi : 10.1056 / NEJMoa0912321 .
  3. ↑ International Carotid Stenting Study Investigators: Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomized controlled trial. In: The Lancet . Vol. 375, No. 9719, 2010, pp. 985-997, PMID 20189239 , doi : 10.1016 / S0140-6736 (10) 60239-5 .
  4. ↑ Jean-Louis Mas et al .: Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. In: The New England Journal of Medicine. Vol. 355, No. 16, 2006, pp. 1660-1671, PMID 17050890 , doi : 10.1056 / NEJMoa061752 .
  5. ↑ The SPACE Collaborative Group: 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomized non-inferiority trial. In: The Lancet. Vol. 368, No. 9543, 2006, pp. 1239-1247, PMID 17027729 , doi : 10.1016 / S0140-6736 (06) 69122-8 .
  6. ↑ Controversies: Carotid endarterectomy versus stent-protected angioplasty in arteriosclerotic stenosis of the internal carotid artery. SpringerMedizin, archived from the original on January 14, 2011 ; accessed on August 25, 2019 .
  7. ↑ Rishi Gupta, Tudor G. Jovin, Dileep Yavagal, Alex Abou-Chebl: Carotid Endarterectomy vs. Carotid Stenting: Fairly Comparable or Unfairly Compared? In: Frontiers in Neurology. Vol. 1, No. 14, 2010, PMID 21173891 , doi : 10.3389 / fneur.2010.00014 .