Using MSCT to Diagnose and Categorize High Bifurcation of the Common Carotid Artery Before Carotid Endarterectomy in Older Individuals

Carotid endarterectomy (CEA) is the mainstay of treatment for carotid artery stenosis for the prevention of ischemic strokes. The variant anatomy of the structure of the brachiocephalic arteries, namely the high bifurcation of the common carotid artery, requires a careful approach to planning surgical intervention. A multidisciplinary approach requires a clear and informative diagnostic algorithm for the examination of patients with high bifurcation of the carotid arteries, involving the collaboration of a radiologist and a vascular surgeon. An attempt to classify variant structural features of the carotid artery bifurcation can help to reduce discrepancies in the diagnosis and the risk of complications associated with surgical intervention. Based on their own experience in managing patients with carotid artery stenosis, the authors have proposed a new guideline for determining and localizing the high bifurcation of the carotid arteries.