A Case of a Rare Branching Pattern in the Carotid Artery

Ayumi Sakai, MD; Kazunobu Hashikawa, MD, PhD; Akiko Sakakibara, MD, PhD; Nobuyuki Murai, MD; Tadashi Nomura, MD, PhD; Masaya Akashi, MD, PhD; Hiroto Terashi, MD, PhD

Disclosures

ePlasty. 2022;22(ic1)

Summary

The authors encountered a case in which selection of an anastomotic artery was difficult because of the rare branching pattern of the carotid artery. Therefore, it should be noted that the FA, LA, and STA sometimes form a common trunk together and that the STA tends to originate from the CCA when the CB exists at a higher level, and an exceptional case in which the STA originates from the CCA at greater than 2 cm proximal to the CB should be considered. Sufficient knowledge of the branching pattern of the carotid artery and its location with the surrounding tissue is important to ensure safe free flap surgery with the ability to adapt to a rare branching pattern.

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Table 1. Frequency of origin of 3 anterior branches
	n	I ECA	I CB	I CCA	II TL-ECA	II TL-CB	II TL-CCA	II TL-ECA	II LF-CB	II LF-CCA	II TLF
Takemura et al. 1997³	31	2(6.4)	16(51.6)	0(0)	5(16.1)	0(0)	0(0)	5(16.1)	1(3.2)	2(6.5)	0(0)
Ozugur et al. 2008⁶	40	12(30)	14(35)	10(25)	0(0)	1(2.5)	0(0)	2(5)	1(2.5)	0(0)	0(0)
Natsis et al. 2011⁵	100	28(28)	38(38)	10(10)	1(1)	1(1)	1(1)	10(10)	10(10)	1(1)	0(0)