Tortuous Carotid Artery: A Case Report from Anatomy Training Body and Anesthetic Consideration for Stellate Ganglion Block
Takutoshi Inoue *
Department of Anatomy, Teikyo University School of Medicine, Tokyo, Japan.
Toru Yamamoto
Division of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
*Author to whom correspondence should be addressed.
Abstract
Carotid tortuosity is a common clinical disorder in which the brachiocephalic or carotid arteries are tortuously prolonged and manifest as a pulsatile mass in the neck. Such arteries are anatomic variants of unknown origin and are usually detected incidentally during surgery or cervical imaging. Females are more likely to have common carotid artery tortuosity than males, and the tortuosity is more prevalent on the right side. There are several risk factors for tortuosity, including aging, obesity, arteriosclerosis, hypertension, and cardiomegaly.
The stellate ganglion block (SGB) is a local anesthetic block of the stellate ganglion using needle. In this report, we herein show the case of a 93-year-old woman who had significant tortuosity of the right common carotid artery at the level of the fifth and sixth cervical vertebrae, which corresponds to the height of the insertion site from an anatomy training body. Careful maneuver is required when performing SGB on the right side of neck in elder women patients who have hypertension and arteriosclerosis with taking account that the tortuosity of the right common carotid artery is more prevalent than that of the left side into consideration so as to prevent intravascular injection errors and hemorrhagic complications during SGB.
This case reminds us the importance of the anatomical knowledge on all medical procedures.
Keywords: Carotid artery tortuosity, common carotid, anatomy training body, stellate ganglion block