Lateral External Carotid Artery: Implications for the Vascular Surgeon

Anatomy of lateral external carotid artery. A) The external carotid artery (long arrow; ECA) is located lateral to the internal carotid artery (short arrow; ICA). The superior thyroid (STA), lingual (LA) and facial (FA) arteries pass antero-medial to the ICA. The hypoglossal nerve (HN) loops around the antero-lateral portion of the ECA and the internal laryngeal nerve (ILN) lies anteriorly on the ICA; the greater horn of hyoid is also in close proximity (*). The vagus nerve (VN) is placed posteriorly. The internal jugular vein has been removed in this specimen. B) Retracting the ECA laterally reveals the ILN, which courses postero-medially beyond the hypoglossal loop, which itself placed under tension. C) The contralateral carotid arteries were orientated normally.

Achieving adequate exposure for carotid endarterectomy in patients with LECA. Circumferential dissection of the ECA allows mobilisation and medial retraction of this artery allowing access to the lateral ICA.