Absence of the Common Carotid Artery: A Rare Vascular Anomaly

A, Simplified diagram shows the ventral aorta (VA) and dorsal aorta (DA), with four pairs of branchial arches (I, II, III, and IV) in a 2- to 4-mm embryo. The fifth and sixth arches are not shown. The part of dorsal aorta between the third and fourth branchial arches is called the ductus caroticus (D).

B, In a normal 12- to 14-mm embryo, the ductus caroticus (D) and most of the first, second, fifth, and sixth arches involute. The proximal portion of the ECA (E) forms the CCA (C). The third arch (III) forms the carotid sinus and proximal portion of the ICA (I). On the left side, the fourth arch forms the aortic arch (A), and on the right side, it forms the brachiocephalic artery (B) and subclavian artery (S).

C, Absence of the CCA may occur if the third branchial arch (III) involutes and the ductus caroticus persists (right) or, alternatively, if the fourth branchial arch (IV) involutes and the persistent third branchial arch forms a cervical aortic arch (left).