CT - Neck CTA
Axial C+ arterial phase
Coronal C+ arterial phase
Coronal MIP
Coronal MIP
Coronal MIP
At what level does the brachiocephalic artery normally divide?
Normally, the brachiocephalic artery divides posterior to the right sternoclavicular joint.
What is an important vascular abberation in this case which is worth reporting to avoid any potential disastrous intraoperative complications?
High-riding brachiocephalic artery above the level of the right sternoclavicular joint, compressing the right thyroid lobe, indenting the adjacent airway.
Elongated brachiocephalic trunk, measuring about 4 cm in length, bifurcating into the right common carotid and subclavian arteries above the level of the right sternoclavicular joint. It appears to compress the right thyroid lobe, indenting the upper airway with mild contralateral deviation. Findings are in keeping with a high-riding brachiocephalic artery.
Elongation and marked anterior kinking of the left common carotid artery.
Retropharyngeal right ICA.