1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)
1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)
1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)
1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)
1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)
1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)
1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)
1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)
1naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

)


  
    





































































    Aortic Arch Origin of the Left External Carotid Artery | American Journal of Neuroradiology  
    



















    































    
  
  




    
    

  

      


    

      

  
  
  

    

  

    

  

                
    

      

  

    

  
      
  
  

    


Advertisement



  



  


  
  



  



    

  


  


  


  
  
  
  
  
  

  	      


    
      

    
  
    
        
    

  

    
                        

  

                
    

      

	  

		
		

			

			  

  
      
  
  

    

  
  
      
LetterLETTER

  
      

  
      
Aortic Arch Origin of the Left External Carotid Artery
  
    	
Sinan Cakirer and Ercan Karaarslan

  
    	
American Journal of Neuroradiology August 2003,  24 (7) 1492; 

  
  
  



  


  
  



			

		

	
	
 	
	  
  

		
		

			

			  

  
      
  
  

    
  


  
  



  
      
  
  

    

  

    

  
      
  
  

    
We read with interest the article by Horowitz et al (1) in the March 2003 issue of the AJNR. The authors described an aortic arch origin of the left external carotid artery associated with a type II preatlantal fetal anastomosis. They claim that their case is unique, because it shows a left external carotid artery originating from the aortic arch.
We would like to draw the authors’ attention to the previously published reports of left external carotid arteries that have separate origins from the aortic arch. A search of the literature starting from 1968 revealed five cases of agenesis of left common carotid artery with separate origins of the left internal and external carotid arteries from the aortic arch. The condition was diagnosed by MR angiography of supraaortic vessels in a case by Cakirer et al (2), by using a combination of intraarterial angiography and duplex sonography in a case by Woodruff et al (3), and by using intraarterial angiography in three other cases by Bryan et al (4), Dahn et al (5), Rossitti et al (6).
The authors also claim that their case is unique in its association with a type II proatlantal intersegmental artery. Lie (7) reported that there were many congenital anomalies associated with separate origins of left internal and external carotid arteries from the aortic arch, including a cervical aortic arch, a double aortic arch, persistent trigeminal artery, and persistent proatlantal segmental artery in an angiographic study and review of congenital anomalies of the carotid arteries.
References
  1. ↵
    Horowitz M, Bansal S, Dastur K. Aortic arch origin of the left external carotid artery and type II proatlantal fetal anastomosis. AJNR Am J Neuroradiol 2003;24:323–325
    Abstract/FREE Full Text
  2. ↵
    Cakirer S, Karaarslan E, Kayabali M, Rozanes I. Separate origins of the left internal and external carotid arteries from the aortic arch: MRA findings. AJNR Am J Neuroradiol 2002;23:1600–1602
    Abstract/FREE Full Text
  3. ↵
    Woodruff WW III, Strunsky VP, Brown NJ. Separate origins of the left internal and external carotid arteries directly from the aortic arch: duplex sonographic findings. J Ultrasound Med 1995;14:867–869
    PubMed
  4. ↵
    Bryan RN, Drewyer RG, Gee W. Separate origins of the left internal and external carotid arteries from the aorta. AJR Am J Roentgenol 1978;130:362–365
    CrossRefPubMed
  5. ↵
    Dahn MS, Kaurich JD, Brown FR. Independent origins of the internal and external carotid arteries: a case report. Angiology 1999;50:755–760
    PubMed
  6. ↵
    Rossitti S, Raininko R. Absence of the common carotid artery in a patient with a persistent trigeminal artery variant. Clin Radiol 2001;56:79–81
    CrossRefPubMed
  7. ↵
    Lie TA. Congenital anomalies of the carotid arteries: an angiographic study and a review of the literature. Amsterdam: Excerpta Medica Foundation;1968;30–35

        Reply:
      
We greatly appreciate the information provided by Drs. Cakirer and Karaarslan regarding prior reports on aortic arch origins of the external carotid artery along with their association with proatlantal vessels. We apologize for incomplete review of the past literature. Once again, we have had it reinforced in our minds that there is rarely “something new under the sun.” In retrospect, perhaps I should mind the valuable advice given to me by my mentor, Dr. Philip Purdy, several years ago, when he urged me never to say something is being reported for the first time, because one can be sure that this is not true.
  


  
  



  
      
  
  

    
  


  
  



  




  


  
  



  
      
  
  

    
  


  
  



  
      
  
  

     Back to top  


  
  



			

		

		
		

			

			  

  
        
In this issue

    
  
  

    
  


  
  



  
      
  
  

    

  

    

  
      
  
  

    


Advertisement



  



  


  
  



  



  


  
  



  
      
  
  

    

	  
  

		

          

            

  
      
  
  

     Print  


  
  



  
      
  
  

    
 Email Article
  


  
  



  
      
  
  

    
 Citation Tools
  


  
  



          

        

        
        

          

            



  
      
  
  

    

  

    

  
      
  
  

    

  
  
  
  
      
Aortic Arch Origin of the Left External Carotid Artery
  
    	
Sinan Cakirer, Ercan Karaarslan

  
    	
American Journal of Neuroradiology Aug 2003, 24 (7) 1492; 

  
  
  



  


  
  



  
      
  
  

    

  
    
  
  
    
  
  
    
  


  


  
  



  
      
  
  

    
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  


  
  



  



  


  
  



  
      
  
  

    
  


  
  



          

        

	
 	
	
	


  


  
  



  
        
Jump to section

    
  
  

    
  


  
  



  
      
  
  

    

  

    
 Related Articles
  • No related articles found.
 Cited By...
  • No citing articles found.
 More in this TOC Section
 Similar Articles

  



  


  
  



			

		

	
	
 	
	
	


    

  



  

                
    

      

  

    

  
      
  
  

    


Advertisement