内頚動脈—発生と変異

Internal Carotid Artery:Development and Anomalies

Point

・内頚動脈の形成には，第1〜3鰓弓動脈と背側大動脈が関与し，特に第3鰓弓動脈の役割が重要である．

・内頚動脈のsegmentationは，発生学的に独立したsegmentに基づき，それぞれのsegmentは特定の発生学的異常，形成不全，または破格に関与する．

・内頚動脈の変異や異常を正確に理解するには，発生学的背景と解剖学的知識が必要であり，その素養を身につけることは臨床的な診断や治療戦略の決定に役立つ．

　This chapter outlines the cerebrovascular developmental anatomy with emphasis on the internal carotid artery（ICA）, which is important for optimal endovascular treatment of cerebrovascular system disorders. Gene expression, neural crest cells, and pharyngeal arches play key roles in the embryonic development of the carotid arteries. Evolutionary inheritance in vertebrates contributes to the formation, regression, and segmental structure of these arteries. We present examples of current mutations with regard to their segmental nature; ICA mutations are discussed primarily with regard to their developmental origin from the first to third pharyngeal arches and the role of the ductus caroticus. This comprehensive review highlights the importance of understanding the developmental and anatomical nuances of the ICA to aid with accurate diagnosis and management of vascular anomalies in the clinical setting. We have focused on the complexity associated with ICA mutations, particularly those associated with the third pharyngeal arch and the need for a solid foundation of developmental and anatomical knowledge to accurately identify and interpret their significance in the adult phenotype.