Clinical implications of variations of common carotid artery trifurcation

Abstract

Introduction and Objective. Common carotid arteries are paired vessels supplying the head and neck, and in surgical practice their trifurcation can impact the effectiveness of various oncologic, reconstructive, and interventional procedures. Understanding anatomical variations is crucial for avoiding complications and improving procedural safety. The aim of the study was to review the literature and systematize knowledge regarding the anatomy of the common carotid a. trifurcation, with particular emphasis on its role in procedures such as carotid a. stenting, carotid endarterectomy, tumour embolization, glossectomy, thyroidectomy, and lymph node resection. Review Methods. A literature review (including 9 original studies and 11 case reports) was conducted, considering studies on the anatomy of the common carotid a. trifurcation based on cadaveric and radiological material. Various variants of the common carotid a. trifurcation were identified, and their frequency of occurrence documented in the study. Brief description of the state of knowledge. Based on the analyzed literature, the most frequently observed third branch of the division was the superior thyroid a. (20-76.6%). Other isolated cases included the superior laryngeal a., ascending pharyngeal a., occipital a., and lingual a. Conclusions. Analyzing the diversity of the common carotid a. trifurcation reveals its frequent occurrence, suggesting the necessity to consider this variability in head and neck medical procedures. The most common third branch is the superior thyroid a., which holds significant importance for diagnostic and therapeutic strategies in the area of the thyroid gland. While cases of large vessels, such as the vertebral a., departing from the trifurcation are rare, their consideration is crucial in procedural planning.