Predicting the Common Carotid Artery Bifurcation: A Comparative Assessment of Landmark-Based Methods

Area of Science:

• Anatomy
• Vascular Surgery
• Medical Imaging

Background:

• The common carotid artery (CCA) bifurcation is a critical anatomical landmark in vascular surgery.
• Accurate, non-invasive methods for locating the CCA bifurcation are needed for improved surgical planning and patient outcomes.
• Existing methods for predicting CCA bifurcation location have limitations.

Purpose of the Study:

• To develop and validate two novel, non-invasive models for predicting the CCA bifurcation location using palpable anatomical landmarks.
• To compare the predictive accuracy of the new models against a previously published method.
• To assess the clinical practicality and potential impact of the new models on patient care.

Main Methods:

• Measurements were taken from the jugular notch (JN), medial border of the clavicle (MBC), and mastoid process (MP) in human donors (n=30).
• Three models were used to predict CCA bifurcation location: Model I (published method), Model II (MBC-MP distance), and Model III (JN-MP distance).
• Predicted locations were compared with actual bifurcation locations using pre- and post-dissection measurements to assess model validity.

Main Results:

• Model I showed significant deviations from actual CCA bifurcation locations on both sides, using both pre- and post-dissection measurements.
• Models II and III demonstrated no significant differences between predicted and actual CCA bifurcation locations.
• The jugular notch (JN) landmark (Model III) may offer greater clinical practicality.

Conclusions:

• Two new non-invasive models (Model II using MBC, Model III using JN) accurately predict CCA bifurcation location.
• These models can enhance preoperative planning, improve surgical outcomes, and increase patient safety in procedures like carotid stenosis treatment.
• Further validation in diverse populations and clinical settings is recommended.