Angioplasty and stenting of left internal carotid artery in cases of abnormal origin of left common carotid (bovine arch)

Hippokratia 2003, 7(3):132-137

Th Gerasimidis, K Konstantinidis, A Kambaroudis, K Papazoglou, D Karamanos, G Sphiroeras, E Zaphiriadou, A Phileli
5th Surgical Dpt, Hippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece


Left common artery arisen from the innominate artery (“Bovine arch” variation) is an anatomical variation which is considered to increase the difficulty of endovascular treatment of carotid occlusive disease. The aim of this study is to present our results and experience in patients with this anatomical variation. It refers to 6 (5.2%) (out of a total 115 cases) male patients with symptomatic carotid occlusive disease, (m.v. 71 years old), all of which had stenosis > 75%, 4 of them with residual neurological sign as well as different concomitant diseases and deteriorating factors (hypertension, hyperlipidaimia, diabetes mellitus). All patients underwent successful endovascular treatment with angioplasty and stenting of internal carotid artery. None of the patients developed any complication involving deterioration of neurological signs. On the contrary, postoperative control came up with improvement of blood flow in carotid arterial system. This study proves that ihbovine archli is not a contradiction for the choice of CAS in carotid stenosis even without the use of distal cerebral protection devices.