Abstract
The occipital artery arises as one of the main branches of the external carotid artery. The goal of the present meta-analysis was to provide a detailed analysis of the complete anatomy of the occipital artery using the available data in the literature. The main online medical databases such as PubMed, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar were used to gather all studies on anatomical variations, course, branches, and the close anatomical area of the occipital artery. A total of 65 studies were indicated, evaluated, and included in this meta-analysis. The occipital artery was found to run in the groove with a prevalence of 83.93% (95% confidence intervals: 50.53–100.00%). The occipital artery forming a common trunk with another artery had a prevalence of 13.91% (95% confidence intervals: 9.15–19.47%). The mean maximal diameter of the occipital artery was set to 2.26 mm (standard error = 0.15). The mean maximal diameter of the occipital segment of the occipital artery was found to be 1.24 mm (standard error = 0.15). The mean occipital artery length was set to 131.93 mm (standard error = 3.02). In conclusion, the authors of the present study believe that this is the most accurate and up-to-date meta-analysis regarding the anatomy of the occipital artery. Knowledge about this structure can be of great use when performing revascularization procedures, such as the occipital artery-posterior inferior cerebellar artery bypass, or reconstructive procedures, such as the occipital artery fascial flap.
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Data Availability Statement
The data that support the findings of this study are available from the corresponding author, upon reasonable request.
References
Abla AA, McDougall CM, Breshears JD, Lawton MT (2016) Intracranial-to-intracranial bypass for posterior inferior cerebellar artery aneurysms: options, technical challenges, and results in 35 patients. J Neurosurg 124:1275–1286. https://doi.org/10.3171/2015.5.JNS15368
Alvernia JE, Fraser K, Lanzino G (2006) The occipital artery: amicroanatomical study. Operative Neurosurg. https://doi.org/10.1227/01.NEU.0000193519.00443.34
Ateş Ö, Ahmed AS, Niemann D, Başkaya MK (2008) The occipital artery for posterior circulation bypass: microsurgical anatomy. Neurosurg Focus 24:E9. https://doi.org/10.3171/FOC/2008/24/2/E9
Ausman JI, Diaz FG, Vacca DF, Sadasivan B (1990) Superficial temporal and occipital artery bypass pedicles to superior, anterior inferior, and posterior inferior cerebellar arteries for vertebrobasilar insufficiency. J Neurosurg 72:554–558. https://doi.org/10.3171/jns.1990.72.4.0554
Barral J, Croibier A (2011) Visceral vascular manipulations. Elsevier, Amsterdam
Benet A, Tabani H, Ding X et al (2018) The transperiosteal “inside-out” occipital artery harvesting technique. J Neurosurg 130:207–212. https://doi.org/10.3171/2017.6.JNS17518
Chmielewski L, Liu MT, Guyuron B (2013) The role of occipital artery resection in the surgical treatment of occipital migraine headaches. Plast Reconstr Surg 131:351e–356e. https://doi.org/10.1097/PRS.0b013e31827c6f71
Cobiella R, Quinones S, Aragones P et al (2021) Anatomic mapping of the collateral branches of the external carotid artery with regard to daily clinical practice. Ann Anat—Anatomischer Anz 238:151789. https://doi.org/10.1016/j.aanat.2021.151789
Crowley RW, Medel R, Dumont AS (2009) Operative nuances of an occipital artery to posterior inferior cerebellar artery bypass. Neurosurg Focus 26:E19. https://doi.org/10.3171/2009.2.FOCUS0911
D’Antoni AV, Tubbs RS, Patti AC et al (2022) The critical appraisal tool for anatomical meta-analysis: a framework for critically appraising anatomical meta-analyses. Clin Anat 35:323–331. https://doi.org/10.1002/ca.23833
Fukuda H, Evins AI, Burrell JC et al (2014) A safe and effective technique for harvesting the occipital artery for posterior fossa bypass surgery: a cadaveric study. World Neurosurg 82:e459–e465. https://doi.org/10.1016/j.wneu.2013.09.015
Guyuron B, Varghai A, Michelow BJ et al (2000) Corrugator supercilii muscle resection and migraine headaches. Plast Reconstr Surg 106:429–434. https://doi.org/10.1097/00006534-200008000-00030
Guyuron B, Tucker T, Davis J (2002) Surgical treatment of migraine headaches. Plast Reconstr Surg 109:2183–2189. https://doi.org/10.1097/00006534-200206000-00001
Heltzel S, Jaynes D (2011) Variation in the branching pattern of the four major caudal vessels emerging from the external carotid artery. FASEB J. https://doi.org/10.1096/fasebj.25.1_supplement.869.6
Henry BM, Tomaszewski KA, Ramakrishnan PK et al (2017) Development of the anatomical quality assessment (AQUA) tool for the quality assessment of anatomical studies included in meta-analyses and systematic reviews. Clin Anat 30:6–13. https://doi.org/10.1002/ca.22799
Higgins JPT, Thomas J, Chandler J et al (eds) (2019) Cochrane handbook for systematic reviews of interventions. Wiley, New York
Iwai T, Izumi T, Inoue T et al (2012) Incidence of the occipital artery arising from the internal carotid artery identified by three-dimensional computed tomographic angiography. Br J Oral Maxillofac Surg 50:373–375. https://doi.org/10.1016/j.bjoms.2011.05.014
Iwanaga J, Singh V, Ohtsuka A et al (2021) Acknowledging the use of human cadaveric tissues in research papers: Recommendations from anatomical journal editors. Clin Anat 34:2–4. https://doi.org/10.1002/ca.23671
Janis JE, Hatef DA, Reece EM et al (2010) Neurovascular compression of the greater occipital nerve: implications for migraine headaches. Plast Reconstr Surg 126:1996–2001. https://doi.org/10.1097/PRS.0b013e3181ef8c6b
Moore KL, Dalley AF, Agur A (2017) Clinically oriented anatomy, 8th edn. Lippincott Williams and Wilkins, Philadelphia
Reinisch JF, van Hövell tot Westerflier CVA, Tahiri Y, Yao CA (2019) The occipital artery–based fascial flap for ear reconstruction. Plast Reconstr Surg 143:592e–601e. https://doi.org/10.1097/PRS.0000000000005263
Seker A, Martins C, Rhoton AL (2010) Meningeal anatomy. Meningiomas. Elsevier, Amsterdam, pp 11–51
Sharma RK, Tuli P (2010) Occipital artery Island V-Y advancement flap for reconstruction of posterior scalp defects. J Plast Reconstr Aesthet Surg 63:410–415. https://doi.org/10.1016/j.bjps.2008.12.017
Shimizu S, Oka H, Osawa S et al (2007) Can proximity of the occipital artery to the greater occipital nerve act as a cause of idiopathic greater occipital neuralgia? An anatomical and histological evaluation of the artery-nerve relationship. Plast Reconstr Surg 119:2029–2034. https://doi.org/10.1097/01.prs.0000260588.33902.23
Small JE, Harrington J, Watkins E (2014) Prevalence of arterial branches arising from the extracranial internal carotid artery on CT angiography. Surg Radiol Anat 36:789–793. https://doi.org/10.1007/s00276-013-1246-6
Sundt TJ, Piepgras D, Fode N (1994) Techniques, results, and complications of occipital and temporal artery bypass pedicles to branches of the Vertebral and Basilar Arteries, in Meyer FB (ed): Sundt’s Occlusive Cerebrovascular Disease, ed 2. W.B. Saunders Company, Philadelphia
Tenna S, Brunetti B, Aveta A et al (2013) Scalp reconstruction with superficial temporal artery island flap: clinical experience on 30 consecutive cases. J Plast Reconstr Aesthet Surg 66:660–666. https://doi.org/10.1016/j.bjps.2013.01.010
Uchino A, Saito N, Mizukoshi W, Okada Y (2011) Anomalous origin of the occipital artery diagnosed by magnetic resonance angiography. Neuroradiology 53:853–857. https://doi.org/10.1007/s00234-010-0825-z
Żytkowski A, Tubbs RS, Iwanaga J et al (2021) Anatomical normality and variability: historical perspective and methodological considerations. Transl Res Anat 23:100105. https://doi.org/10.1016/j.tria.2020.100105
Acknowledgements
The authors are beholden to Mr. Jacenty Urbaniak for the technical support. “The authors wish to sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially improve patient care and increase mankind’s overall knowledge. Therefore, these donors and their families deserve our highest gratitude” (Iwanaga et al. 2021).
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Dr Mateusz Koziej was supported by the Foundation for Polish Science (FNP). The funders had no role in the study’s design, data collection, or analysis, decision to publish, or preparation of the manuscript. The rest of the authors received no financial support for the research, authorship, and/or publication of this article.
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Ostrowski, P., Bonczar, M., Plutecki, D. et al. The occipital artery: a meta-analysis of its anatomy with clinical correlations. Anat Sci Int 98, 12–21 (2023). https://doi.org/10.1007/s12565-022-00693-4
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DOI: https://doi.org/10.1007/s12565-022-00693-4