Skull Base 2007; 17 - A126
DOI: 10.1055/s-2007-981831

The Anatomy of the Ascending Pharyngeal Artery and Its Implication for Neurosurgical and Endovascular Procedures

Daniel Cavalcanti 1(presenter), Cassius V.C Reis 1, Ricardo Hanel 1, Sam Safavi-Abassi 1, Pushpa Deshmukh 1, Robert F Spetzler 1, Mark C Preul 1
  • 1Phoenix, USA

Introduction: The ascending pharyngeal artery (APA) is a branch of the external carotid artery (ECA). Classically, APA is held to be the first branch of the ECA and can act as a blood supplier to intracranial and skull base lesions. We studied the anatomy of the APA in the context of neurosurgical and endovascular implications.

Methods: The cervical origin, branching pattern, and course of the APA were studied in 20 human cadaveric sides. Relationships of the APA and surrounding structures, its diameter, extension of its main trunk, and distance of its origin to the common carotid artery bifurcation (CCAb) were measured.

Results: APA originated from ECA in 80% of specimens. It originated from the ECA medial wall in 56%. Other origins were internal carotid artery, CCAb, occipital artery, and a common trunk with lingual and facial arteries. Forty percent of specimens showed the APA as the third branch of the ECA and mean distance from the APA origin to the CCAb was approximately 15.3 mm.

Conclusion: APA is an important channel for supplying posterior fossa structures. Knowledge of its anatomy and variations is essential to treating lesions supplied by its branches and to avoid complications related to its inadvertent injury, especially when using an endovascular approach.