Artery, Common Carotid

The common carotid artery (CCA) bifurcates into the internal carotid artery and external carotid artery.



In general, the ICA origin (green arrow) is postero-lateral to the ECA origin (red arrow), as seen on this left CCA roadmap.


This patient presented with a sudden onset of right hemiparesis and dysphasia. A severe left CCA origin stenosis (A, yellow arrow) was revealed on the DSA which obstructed the catheterization of the left CCA. By the time the right CCA/ ICA was catheterized, contrast stasis was still present in the left CCA (B) due to insufficient forward flow. A left M2 occlusion (C, red arrow) was confirmed on the right ICA injection by cross-filling of the contrast via the ACOM artery. Also identified was the left ACA collaterals (D, green arrows) and retrograde flow into the left ICA (C and D). A direct left CCA puncture under the guidance of the ultrasound was performed and a TICI 2B reperfusion was achieved after mechanical thrombectomy (E and F).