Angiographic Characterization of the External Carotid Artery: Special Attention to Variations in Branching Patterns

Abstract

Knowledge of branching patterns of external carotid artery (ECA) is essential for planning and execution of head and neck surgeries. Digital subtraction angiography (DSA) images of 532 ECAs from 302 consecutive patients were retrospectively evaluated. We classify the branch variants of ECA into three types, simply based on the number of branches arising close together. Type A, Type B, and Type C variants are defined as two, three, and four or more branches of ECAs arising at a common point from the proximal ECA, respectively. In this classification, the distal ECA was counted as one branch. Of 532 ECAs, Type A was found in 344 ECAs (64.6%) of 237 patients (78.5%), Type B in 134 ECAs (25.2%) of 110 patients (36.4%), and Type C in 54 ECAs (10.2%) of 49 patients (16.2%). The distance from the common carotid artery (CCA) bifurcation to the first branch of ECA with Type C was 14.7 ± 6.6 mm; its distance is shorter compared with Type A (21.8 ± 15.6 mm) and Type B (20.6 ± 8.9 mm) (P < 0.05). The position of CCA bifurcation with Type C was detected at the third-fourth junction cervical vertebral level or higher in 52 of 54 ECAs (96.3%), significantly higher than those of the other types (P < 0.05). In conclusion, Type C ECA has aggregated vessels with short distance from CCA and high position of CCA bifurcation. Type C ECA is not uncommon; thus, special consideration should be paid to avoid complications during surgeries.

Assessment of Aptamer-Targeted Contrast Agents for Monitoring of Blood Clots in Computed Tomography and Fluoroscopy Imaging

“…The occlusion of R ECA was successfully visualized, as contrast distribution was no longer observed past the location of the clot (dotted line, Figure S7). In the control tissue, the left external, internal, and common carotid arteries (L ECA, L ICA, and L CCA, respectively) were all clearly visible, due to the presence of dark contrast which highlighted the characteristic branching of ECA. ,, …”

“…In the control tissue, the left external, internal, and common carotid arteries (L ECA, L ICA, and L CCA, respectively) were all clearly visible, due to the presence of dark contrast which highlighted the characteristic branching of ECA. 5,52,53 Again, it is important to consider the characteristics of the clots being used in these experiments. All clots were made using whole blood with regular circulating concentrations of fibrinogen (2−5 mg/mL), which formed red blood cell (RBC)-rich blood clots.…”

Ascending palatine branch from the lingual artery with multiple other variations of the external carotid artery

“…In a study of 302 patients, Yamamoto et al determined the incidences of ECA branching patterns by analyzing 532 ECAs using digital subtraction angiography. They classified these arteries into three categories (A, B, C) based on the number of branches (two, three, four or more) emerging from the proximal ECA at a common point, the distal ECA counting as one branch [14]. Using this criterion, Type A (two branches) is defined as all individual branches arising separately from the proximal ECA.…”

“…They also found that 96.3% of Type C ECAs had a CCA bifurcation at the level of the junction of the thirdfourth cervical vertebrae or higher, which was significantly higher than the bifurcation in Type A or B. Because there are several anatomical variations, it is imperative that surgeons be aware of the Type C variation to avoid unexpected complications [14] An anatomical variation of the ascending palatine artery, branching from the lingual artery instead of the facial artery, has been noted in previous literature. Unfortunately, we could find no more details of this variation [11].…”

Development and characterization of aptamer-conjugated imaging tools for diagnostic applications

“…As above, the incubations were left to equilibrate for 45-minutes with FB139-AuNPs, iopamidol, and all clearly visible, due to the presence of dark contrast which highlighted the characteristic branching of ECA. 152,231,232 Again, it is important to consider the characteristics of the clots being used in these experiments. All clots were made using whole blood with regular circulating concentrations of fibrinogen (2-5 mg/mL), which formed red blood cell (RBC)-rich blood clots.…”