Abstract
Purpose
It is well known that many anastomoses can join the external carotid system and the ophthalmic artery. However, their frequency has never been reported. Since they can be relevant for interventional radiologists operating in the orbit, we decided to illustrate and determine the frequency of the anastomoses that can be found in children.
Methods
A retrospective study of 443 angiographic procedures (via ophthalmic artery and/or external carotid artery) carried out on 97 children affected by intraocular retinoblastoma was made to investigate the arterial anatomy of 106 orbits.
Results
Anastomoses were observed in 44.33 % of orbits. However, their true frequency is likely much higher as the rate of visualization increased up to 91.11 % of orbits when the angiographic study was extended to the external carotid artery. In order of frequency we detected the following anastomoses: lacrimal artery—middle meningeal artery, lacrimal artery—anterior deep temporal artery, ophthalmic artery—middle meningeal artery, ophthalmic artery—facial artery, supraorbital artery—superficial temporal artery, supratrochlear artery—superficial temporal artery, supraorbital artery—middle meningeal artery, dorsal nasal artery—infraorbital artery, supraorbital artery—zygomaticoorbital artery, lacrimal artery—zygomaticoorbital artery.
Conclusion
When properly searched, anastomoses between the ophthalmic artery and the external carotid artery are almost constant in children. Depending on the clinical scenario, they can represent dangers or valuable alternative routes for collateral circulations and intraarterial chemotherapy.
Similar content being viewed by others
References
Agid R, Terbrugge K, Rodesch G, Andersson T, Söderman M (2009) Management strategies for anterior cranial fossa (ethmoidal) dural arteriovenous fistulas with an emphasis on endovascular treatment. J Neurosurg 110:79–84
Ahn HS, Kerber CW, Deeb ZL (1980) Extra- to intracranial arterial anastomoses in therapeutic embolization: recognition and role. Am J Neuroradiol 1:71–75
Amans MR, Narvid J, Halbach VV (2014) Intra-arterial chemotherapy for bilateral retinoblastoma via left ophthalmic artery and right anterior deep temporal artery. BMJ Case Reports. doi:10.1136/bcr-2014-204549
Berthelot JL, Hureau J (1982) Clinical anatomy study of the macroscopic anastomoses of the ophthalmic artery in the periorbital region. Clin Anat 3:271–278
Bron AJ, Tripathi RC, Tripathi BJ (2001) The orbital and cerebral vessels. In: Bron AJ, Tripathi RC, Tripathi BJ (eds) Wolff’s anatomy of the eye and orbit, 8th edn. Arnold, London, pp 84–106
Clay CL, Saint-Michel D, Vignaud J, Moret J, Lasjaunias P (1976) Apport de la carotide externe à la vascularisation de l’orbite. Arch Ophtalmol 36:475–490
Cooke D, Farid H, Kim W, Dowd C, Higashida R, Halbach V (2012) Zygomatico-orbital intra-arterial melphalan infusion for intraocular retinoblastoma. J Neurointerv Surg 4:e16
Countee RW, Vijayanathan T (1979) External carotid artery in internal carotid artery occlusion. Angiographic, therapeutic, and prognostic considerations. Stroke 10:450–460
Diamond MK (1991) Homologies of the meningeal-orbital arteries of humans: a reappraisal. J Anat 178:223–241
Ducasse A, Segal A, Delattre JF, Burette A, Flament JB (1985) La participation de l’artère carotid externe à la vascularisation orbitaire. J Fr Ophtalmol 8:333–339
Geibprasert S, Pongpech S, Armstrong D, Krings T (2009) Dangerous extracranial-intracranial anastomoses and supply to the cranial nerves: vessels the neurointerventional needs to know. Am J Neuroradiol 30:1459–1468
Gobin YP, Dunkel IJ, Marr BP, Brodie SE, Abramson DH (2011) Intraarterial chemotherapy for the management of retinoblastoma. Arch Ophthalmol 129:732–737
Hayreh SS (1962) The ophthalmic artery. III. branches. Br J Ophthalmol 46:212–247
Hayreh SS (1963) Arteries of the orbit in the human being. Br J Surg 50:938–953
Hayreh SS (2006) Orbital vascular anatomy. Eye 20:1130–1144
Kendall B, Moseley I (1977) Therapeutic embolisation of the external carotid arterial tree. J Neurol Neurosurg Psychiatry 40:937–950
Klufas MA, Gobin YP, Marr B, Brodie SE, Dunkel IJ, Abramson DH (2012) Intra-arterial chemotherapy as a treatment for intraocular retinoblastoma: alternatives to direct ophthalmic artery catheterization. Am J Neuroradiol 33:1608–1614
Lasjaunias P, Michotey P, Vignaud J, Clay C (1975) II- Radioanatomie de la vascularisation artérielle de l’orbite, a l’exception du tronc de l’artére ophthalmique. Ann Radiol 18:181–194
Meldrum ML, Tse DT, Benedetto P (1998) Neoadjuvant intracarotid chemotherapy for treatment of advance adenoid cystic carcinoma of the lacrimal gland. Arch Ophthalmol 116:315–321
Moore KL, Dalley AF (1999) Clinically oriented anatomy, 4th edn. Lippincott Williams & Wilkins, Baltimore Philadelphia
Moret J, Lasjaunias P, Théron J, Merland JJ (1977) The middle meningeal artery. Its contribution to the vascularization of the orbit. J Neuroradiol 4:225–248
Perrini P, Cardia A, Fraser K, Lanzino G (2007) A microsurgical study of the anatomy and course of the ophthalmic artery and its possibly dangerous anastomoses. J Neurosurg 106:142–150
Smith TP (2006) Embolization in the external carotid artery. J Vasc Interv Radiol 17:1897–1912
Snell RS (1995) Clinical anatomy, 5th edn. Little Brown & Co, Boston
Testut L (1923) Trattato di anatomia umana, 3rd edn. UTET, Turin
Tse DT, Benedetto P, Morcos JJ, Johnson TE, Weed D, Dubovy S (2006) An atypical presentation of adenoid cystic carcinoma of the lacrimal gland. Am J Ophthalmol 141:187–188
Venturi C, Bracco S, Cerase A, Cioni S, Galluzzi P, Gennari P, Vallone IM, Tinturini R, Vittori C, De Francesco S, Caini M, D’Ambrosio A, Toti P, Renieri A, Hadjistilianou T (2013) Superselective ophthalmic artery infusion of melphalan for intraocular retinoblastoma: preliminary results from 140 treatments. Acta Ophthalmol 91:335–342
Vignaud J, Hasso AN, Lasjaunias P, Clay C (1974) Orbital vascular anatomy and embryology. Radiology 111:617–626
Willinsky R, Lasjaunias P, Berenstein A (1987) Intracavernous branches of the internal carotid artery (ICA). Comprehensive review of their variations. Surg Radiol Anat 9:201–215
Acknowledgments
We are indebted to Dr. Irene Grazzini, to Dr. Mauro Caini, to Dr. Rebecca Tinturini of the Azienda Ospedaliera Universitaria Senese for their invaluable help in managing our little patients.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
We declare that we have no conflict of interest.
Rights and permissions
About this article
Cite this article
Bracco, S., Venturi, C., Leonini, S. et al. Transorbital anastomotic pathways between the external and internal carotid systems in children affected by intraocular retinoblastoma. Surg Radiol Anat 38, 79–87 (2016). https://doi.org/10.1007/s00276-015-1519-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-015-1519-3