Yet another technique named "the internal to external (INT-EX) technique", described by Rao and team is a stepwise dissection technique of carotid body tumors from the internal carotid towards the external carotid
Prior to resection of large tumors 4D-CTA may be helpful to evaluate the need for preoperative embolization of external carotid
artery feeding vessels to minimize intraoperative bleeding during surgical resection.
DSA of the bilateral external carotid
artery showed that the tumor was supplied by the bilateral occipital artery, and the right occipital artery was the main nutrient artery.
A study done at the Ninth People's Hospital, Shanghai Jiao Tong University concluded coil embolization by angiography of pseudoaneurysms coming off the external carotid
artery is a useful alternative to standard surgical repair and avoids morbidity associated with performing surgery in the face and neck area .
Surgical repair comprises primary arteriorrhaphy, end-to-end anastomosis, vein grafting, polytetrafluoroethylene (PTFE) patching, and transposition of external carotid
to injured ICA [9, 23,48].
The scalp derives its blood supply mainly from the four superficial branches of the external carotid
artery, the superficial temporal, angular, occipital, and posterior auricular arteries, and the supraorbital and supratrochlear branches of the internal carotid.
Multiple vascular-like structures having the same diameter of the internal jugular vein and external carotid
artery were visualised (Figures 1 and 2).
Both internal and external carotid
arteries are patent, however, filling via collateral flow.
The flow velocities in the common carotid artery, internal carotid artery, and external carotid
artery were measured from ultrasonographic examinations, as described previously .
The condition usually strikes older adults, and often affects the temporal artery, which leads from the external carotid
artery on either side of the neck up to the scalp in front of the ear, in the area of the temple.
However, angiographic evidence of HPC demonstrates dual blood supply from internal carotid or vertebral arteries (pial) and external carotid
arteries (meningeal-dural), with dominant supply from the internal carotid circulation [2, 8].