External Cartoid Artery: Imaging Anatomy Atlas for Endovascular Treatment

217 Pages·2020·64.706 MB·English

by  Hiro Kiyosue

Hiro Kiyosue
Editor
External Carotid Artery
Imaging Anatomy Atlas for Endovascular
Treatment
123
External Carotid Artery
Hiro Kiyosue
Editor
External Carotid Artery
Imaging Anatomy Atlas for Endovascular
Treatment
Editor
Hiro Kiyosue
Department of Radiology
Oita University Hospital
Yufu, Oita, Japan
ISBN 978-981-15-4785-0 ISBN 978-981-15-4786-7 (eBook)
https://doi.org/10.1007/978-981-15-4786-7
© Springer Nature Singapore Pte Ltd. 2020
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Contents
1 External Carotid Artery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Hiro Kiyosue
2 Anterior (Visceral) Branches from the Proximal ECA
(Superior Thyroidal, Lingual, and Facial Arterial System) . . . . . . . . . . . . . . . . . . . 7
Hiro Kiyosue
3 Posterior (Neural) Branches from the Proximal ECA . . . . . . . . . . . . . . . . . . . . . . . . 37
Hiro Kiyosue and Yuji Matsumaru
4 Superficial Arteries from the Distal ECA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Hiro Kiyosue
5 Maxillary Artery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109
Hiro Kiyosue and Shuichi Tanoue
v
External Carotid Artery 1
Hiro Kiyosue
The external carotid artery (ECA) gives off various branches of ventral parts of arterial plexus from the 1st and the 2nd
supplying musclocutaneous organs, visceral organs (phar- aortic arch form some of the branches of the ECA (Fig. 1.3).
ynx, oral cavity, larynx, and thyroid), cranial nerves, facial The proximal portion of the second arch forms the ventral
and skull bones, and dura matter. It communicates to the pharyngeal artery further becoming the trunk of the facial and
cerebral arteries and ophthalmic artery via various potential lingual artery. Carotid-vertebrobasilar anastomoses is another
anastomoses. It is essential for successful and safe endovas- important communication in embryo, which exist between
cular treatment to know imaging anatomy of the ECA and its the dorsal aorta and the vertebra-basilar artery. Carotid-
branches particularly these potential anastomoses and cra- vertebrobasilar anastomoses include primitive trigeminal
nial nerve supply. artery, primitive otic artery, primitive hypoglossal artery, and
The external carotid artery (ECA) generally originates the 1st and 2nd proatlantal arteries. The carotid-vertebrobasi-
anteromedially from the common carotid artery at the level lar anastomoses regress and disappear according to the devel-
of C4. The ECA gives off the superior thyroid artery inferi- opment of vertebrobasilar arterial system except for case of
orly at its origin, and runs superiorly toward the parotid rare anatomical variant. The ascending pharyngeal artery and
gland with giving off the lingual artery and the facial artery the occipital artery are partially formed from the primitive
anteriorly, the occipital artery, the ascending pharyngeal hypoglossal artery and the proatlantal artery, respectively.
artery, and the posterior auricular artery posterosuperiorly. The middle meningeal artery and the maxillary artery are
After it penetrates the parotid gland, it bifurcates into two formed from ventral part of the remnant arterial plexus of the
terminal branches of the superficial temporal artery and the 1st and 2nd aortic arch which connect with the hyoid artery
maxillary artery at the level of mandibular neck (Figs. 1.1 (dorsal stem of the remnant second aortic arch) via a transient
and 1.2). embryologic artery called the stapedial artery. The stapedial
Branches of the ECA are delivered from the remnants of artery runs through the stapes in the tympanic cavity and is
the embryological arteries including the 1st and the 2nd aortic divided into two terminal branches of supraorbital division
arch (communicating between the ventral and dorsal aorta) and maxillomandibular division. The former becomes the
and carotid-vertebrobasilar anastomoses (communicating middle meningeal artery and the later becomes the maxillary
between the dorsal aorta and the vertebral/basilar artery) [1– artery. The stapedial artery regresses and disappears accord-
3]. Therefore, various potential anastomoses exist between ing to the development of the stem of the ECA, and the resid-
the ECA and the internal carotid artery or vertebrobasilar ual parts of the stapedial artery becomes small branches the
artery. Six paired aortic arches are formed between the ven- ECA distribute the tympanic cavity. As described above, the
tral aorta and dorsal aorta in the six pharyngeal arches at early ECA is formed by various process of the regression of the 1st
embryo. These aortic arches are formed in order from cranial and 2nd aortic arch and the arterial plexus, embryological
to caudal, and the 1st and 2nd aortic arch becomes arterial anastomoses, and formation of newly developed arterial
plexus and then regressed. The dorsal aorta cranial to the third routes, and therefore, various potential anastomoses and sev-
aortic arch becomes the internal carotid artery. The remnants eral anatomical variations can exist.
H. Kiyosue (*)
Department of Radiology, Oita University Hospital, Oita, Japan
e-mail: [email protected]
© Springer Nature Singapore Pte Ltd. 2020 1
H. Kiyosue (ed.), External Carotid Artery, https://doi.org/10.1007/978-981-15-4786-7_1
2 H. Kiyosue
Fig. 1.1 Schematic drawing
of the external carotid artery
and its major branches. SThA,
superior thyroid artery; ICA,
internal carotid artery; ECA, ADTA MDTA
external carotid artery; LA,
lingual artery; Facial A, facial MMA
artery; APA, ascending
IOA
pharyngeal artery; APalA,
ascending palatine artery; OA, 1
2 STA
occipital artery; PAA,
AMA
posterior auricular artery; SPA 3 TFA Parotid gland
4
STA, superficial temporal PSDA
artery; TFA, transverse facial
artery; MMA, middle
meningeal artery; AMA, DPA PAA
accessory meningeal artery;
IDA, inferior dental artery; Max
MDTA, middle deep temporal IDA
artery; Max, maxillary artery;
ADTA, anterior deep
temporal artery; DPA, deep OA
palatine artery; PSDA, APalA
posterior superior dental APA
artery; IOA, inferior orbital
artery; SPA, sphenopalatine ECA
artery; 1, artery of superior
orbital fissure; 2, artery of ICA
foramen rotundum; 3, artery
of pterygoid canal (vidian Facial A
LA
artery); 4, pharyngeal artery
(pterygovaginal artery) SThA
1 External Carotid Artery 3
MDTA
MMA-OPA MMA-OPA
MMA IOA MMA
ADTA IOA
ADTA MDTA
STA
Max AMA Max AMA STA
SPA
TFA SPA
DPA DPA
PSDA
PSDA
IDA LPA LPA IDA
PAA GPA
GPA
OA
OA APA
ECA APalA Facial A APalA
ICA Facial A ECA
ICA
LA
SThA

SThA LA a b
MMA-OPA
MMA
MDTA
Max
AMA SPA
STA
DPA
IDA
IOA
GPA
PAA
APA
OA Facial A
APalA
ECA
ICA
LA
SThA
c
Fig. 1.2 Angiographic images of the right external carotid artery in a transverse facial artery; MMA, middle meningeal artery; AMA, acces-
case of occlusion of the right internal carotid artery. Right lateral view sory meningeal artery; IDA, inferior dental artery; MDTA, middle deep
(a) and left lateral view (b) of the 3D VR images and, and right anterior temporal artery; Max, maxillary artery; ADTA, anterior deep temporal
oblique view (c) of the common carotid angiography. SThA, superior artery; DPA, deep palatine artery; LPA, lesser palatine artery; GPA,
thyroid artery; ICA, internal carotid artery; ECA, external carotid greater palatine artery; PSDA, posterior superior dental artery; IOA,
artery; LA, lingual artery; Facial A, facial artery; APA, ascending pha- inferior orbital artery; SPA, sphenopalatine artery; MMA-OA, anasto-
ryngeal artery; APalA, ascending palatine artery; OA, occipital artery; mosis between the anterior branch of the middle meningeal artery and
PAA, posterior auricular artery; STA, superficial temporal artery; TFA, the ophthalmic artery
4 H. Kiyosue
Caudal di v
OtV
Longitudinal neural arter y
V VII VIII
X
PTA XI
IX
Cranial d iv POA XI Caudal di v OtV XII
1st 2nd XII V
OpV 3rd DorA PMaxA PTAB A hyoid a PHA
Cranial div DorA (2nd arch) C1
PMaxA VentA 4th PHA C1
POlfA
OpV
3rd
6th PPA VPA 4th PPA
POlfA VA
PManA
(1s t arch ) DA
a SCA b

PcomA
PcomA MHT V MMA
SupOrbit div
V
VODPOAP A MHT BA BA PB
Staped. a VidA CTA(hyoid a )
hyoid a
PManA APOAA APC IDA STA APA OA C1
ICA MaxA ICA VA
Mand. div VA
Facial A
Primitive ECA CCA Lingual A CCA
ECA
Aortic arch SThA
SCA c SCA d
Fig. 1.3 Embryonic development of external carotid artery. Schematic nerve; PPA, primitive proatlantal artery; ASA, anterior spinal artery;
drawing of (a) CRL 4 mm, (b) CRL 9 mm, and (c) CRL 18 mm embryo VPA, ventral pharyngeal artery; PManA, primitive mandibular artery;
(d) after birth. (a) DorA, dorsal aorta; 1st, first aortic arch; 2nd, second BA, basilar artery; hypod a, hypoid artery; VA, vertebral artery; CCA,
aortic arch; 3rd, third aortic arch; 4th, forth aortic arch; 6th, 6th aortic common carotid artery; ECA, external carotid artery; ICA, internal
arch; C1, 1st cervical spinal nerve; VentA ventral aorta; PMaxA, primi- carotid artery; OA, occipital artery; APA, ascending pharyngeal artery;
tive maxillary artery; POlfA, primitive olfactory artery; OpV, optic hyoid a, hyoid artery; staped a, stapedial artery; Mand. Div, mandibular
vesicle; Cranial div, cranial division; Caudal div, caudal division; division; SupOrbit div, supraorbital division; DOPA, dorsal ophthalmic
V-XII,5th–12th cranial nerves; OtV, otic vesicle; PTA, primitive tri- artery; VOPA, ventral ophthalmic artery; PcomA, posterior communi-
geminal artery; POA, primitive otic artery; PHA, primitive hypoglossal cating artery; SCA, subclavian artery. (d) MHT, meningohypophyseal
artery; PPA. Primitive proatlantal artery. (b) DA, dorsal aorta; 1st, first trunk; V, 5th cranial nerve; C1, 1st cervical spinal nerve; VidA, vidian
aortic arch; 2nd, second aortic arch; 3rd, third aortic arch; 4th, forth artery; APC; artery of pterygoid canal; BA, basilar artery; SCA, subcla-
aortic arch; C1, 1st cervical spinal nerve; PMaxA, primitive maxillary vian artery; VA, vertebral artery; CCA, common carotid artery; ECA,
artery; POlfA, primitive olfactory artery; OpV, optic vesicle; Cranial external carotid artery; ICA, internal carotid artery; OA, occipital
div, cranial division; Caudal div, caudal division; V,XI, XII,5th, 11th, artery; APA, ascending pharyngeal artery; CTA (hyoid a), caroticotym-
12th cranial nerves; OtV, otic vesicle; PTA, primitive trigeminal artery; panic artery (hyoid artery); SthA, superior thyroid artery; LA, lingual
PHA, primitive hypoglossal artery; PPA. Primitive proatlantal artery; artery; Facial A, facial artery; APA, ascending pharyngeal artery; OA,
VPA, ventral pharyngeal artery; PManA, primitive mandibular artery; occipital artery; STA, superficial temporal artery; Max, maxillary
BA, basilar artery; hyoid a, hyoid artery; VA, vertebral artery; SCA, artery; IDA, inferior dental artery; MMA, middle meningeal artery; PB,
subclavian artery. (c) MHT, meningohypophyseal trunk; V, 5th cranial petrosal branch of middle meningeal artery; SCA, subclavian artery
1 External Carotid Artery 5
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Berlin: Springer; 2001. p. 15–87.
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embryo. Contrib Embryol. 1948;32:205–61.
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