Angiographic Investigation of Variations in the Branches of the External Carotid Artery: an Anatomic Guide for Intra-arterial Infusion Chemotherapy of Head and Neck Cancer

Angiographic Investigation of Variations in the Branches of the External Carotid Artery: an Anatomic Guide for Intra-arterial Infusion Chemotherapy of Head and Neck Cancer Hiroshi TANAKA, Shoko FUKUSHIMA, Takashi YOSHINOBU, Takashi SHIMADA1), Takashi SHIZUKUISHI2), Naoya ISHIBASHI2), Satoru FURUHASHI2) and Motoichiro TAKAHASHI2) Department of Radiology, Surugadai Nihon University Hospital 1)Department of Radiological Technology, Surugadai Nihon University Hospital 2)Department of Radiology, Nihon University School of Medicine It is important to understand the definitive and stereotaxic vascular anatomy of the external carotid artery (ECA) in order to apply effective and safe transcatheter intraarterial infusion chemotherapy for head and neck cancer. We analyzed the branching patterns of the superior thyroid, lingual, facial, occipital and ascending pharyngeal arteries based on 105 digital subtraction external carotid arteriograms from patients with various head and neck cancers (82 males and 23 females; mean age, 65.8 years; age range, 26–88 years old ). The superior thyroid, lingual, facial, occipital or ascending pharyngeal arteries most often arose directly from the ECA in 46%, 67%, 72%, and 46% of subjects, respectively. The linguofacial, thyrolingual or thyrolinguofacial common trunks were more frequently noticed compared with previous reports. Branching of the superior thyroid artery toward the ventral direction was most often observed in 52% of the cases and the proximal portion of the artery showed obtuse, downward angulation in 58% of the cases. The occipital artery arose from between the facial and lingual arteries of the ECA in 50% of the cases. In the cases with linguofacial common trunk, the occipital artery arose from the distal portion of the common trunk branching in 73%. These angiographic analyses of the branching ECA are clinically useful to effectively and safely advance intra-arterial infusion chemotherapy for head and neck cancers.