Descending musculospinal branch of the ascending pharyngeal artery as a feeder of carotid body tumors: angio-architecture and embryological consideration

Publication date: Available online 10 November 2018

Source: Journal of Neuroradiology

Author(s): Shunsuke Shibao, Takenori Akiyama, Hiroyuki Ozawa, Toshiki Tomita, Kaoru Ogawa, Kazunari Yoshida

Abstract

Introduction Although the ascending pharyngeal artery (APhA) is known as a main feeder of carotid body tumors (CBTs), its detailed architecture and embryological consideration have not been described. The objective of this study was to describe the architecture of a descending feeder of the APhA and to consider its origin embryologically through a review of our CBT embolizations.

Methods We retrospectively analyzed data from patients with CBTs who underwent transarterial embolization or angiographic examination–only between July 2010 and February 2017. The arterial supply of the tumors, the number of feeder pedicles, the mean tumor size, embolization materials, complication of embolization, and extent of tumor removal were assessed. The embryological origin of feeding artery was considered based on the literature.

Results Eighteen patients with 20 CBTs underwent preoperative embolization or angiographic examination. The number of feeder pedicles was significantly related to the size of the CBT (p = 0.0002). The main feeding artery was the descending branch of APhA, which was hypertrophied and tortuous (18/20, 90%). Embryologically, this artery originated from the musculospinal branch and is termed the "descending musculospinal branch".

Conclusion The main feeder of the CBTs was the "descending musculospinal branch" of the APhA and needs special consideration such as dangerous anastomosis for embolization.

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