Variation in distribution of level of bifurcation of the common carotid artery among black African population in western, Kenya

Lisa Wambui Macharia; Dominic Marera; Walter Adero

doi:10.51867/ajernet.7.3.19

Authors

Lisa Wambui Macharia Department of Human Anatomy, School of Medicine, Maseno University, Kenya
Prof. Dominic Marera Department of Human Anatomy, School of Medicine, Maseno University, Kenya https://orcid.org/0000-0001-7052-4377
Dr. Walter Adero Department of Human Anatomy, School of Medicine, Maseno University, Kenya https://orcid.org/0009-0001-0202-8651

DOI:

https://doi.org/10.51867/ajernet.7.3.19

Keywords:

Anatomical Variation, Bifurcation, Black African Population, Common Carotid Artery, Hyoid Bone, Thyroid Cartilage, Upper Border of Thyroid Cartilage

Abstract

Variations in the bifurcation of the common carotid artery (CCA) are clinically important because they influence the safety and effectiveness of carotid angiography, endarterectomy, thyroid surgery, and other head and neck interventions. Several studies have shown inconsistent incidences of CCA variations, with only reports of a single case study, used non homogenous study sample or failed to correlate the variations with the populace demographic characteristics such as sex and laterality. Although such variations have been documented in different populations, there is limited anatomical data among Black Africans in Kenya. This study evaluated the anatomical variations in the bifurcation of the CCA and assessed their association among the Black African population in Western Kenya. A descriptive cross-sectional cadaveric study was conducted in the anatomy laboratories of universities in western Kenya. Seventy-two embalmed adult cadavers of Black African descent, with 57 males (114 arteries) and 15 females (30 arteries) were examined, yielding a total of 144 carotid artery specimens. Standard dissection techniques were used to expose the common carotid arteries from their origin to their terminal bifurcation. Data were analysed using IBM SPSS version 27. Frequencies and percentages were used to summarize anatomical patterns. Majority of common carotid arteries bifurcated at the superior border of the thyroid cartilage 120 (83.3%), while 18 (12.5%) bifurcated at the body of the thyroid cartilage and 6 (4.2%) at the body of the hyoid bone, representing high bifurcation. Thus significant anatomical variations exist in the bifurcation, of the common carotid artery among the Black African population in Western Kenya. The right common carotid artery presented with a higher frequency as compared to the left. These findings provide important region-specific anatomical reference data that can enhance surgical planning, improve radiological interpretation, and reduce the risk of vascular injury during head and neck procedures.

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Author Biographies

Prof. Dominic Marera, Department of Human Anatomy, School of Medicine, Maseno University, Kenya

Head of Department
Dr. Walter Adero, Department of Human Anatomy, School of Medicine, Maseno University, Kenya

Senior Lecturer

References

Anangwe, D., Saidi, H., Ogeng'o, J., & Awori, K. O. (2008). Anatomical variations of the carotid arteries in adult Kenyans. East African Medical Journal, 85(5), 244-247. https://doi.org/10.4314/eamj.v85i5.9619

Biskupski, M., Homzar, S., Dąbrowska, Z., Buczek, J., Daniluk, A., Iwaniuk, K., ... & Ostański, J. (2024). Clinical implications of variations of common carotid artery trifurcation. Journal of Pre-Clinical and Clinical Research, 18(1), 83-87. https://doi.org/10.26444/jpccr/186029

Borges, A., Ramalho, S., & Ferreira, L. (2021). Common carotid artery trifurcation: a potentially dangerous anatomical variant. BMJ Case Reports, 14(2), e241104. https://doi.org/10.1136/bcr-2020-241104

Erete, E. I., Ogun, O. G., Oladapo, O. O., & Akang, E. E. (2012). Prevalence and severity of atherosclerosis in extra cranial carotid arteries in Nigeria: an autopsy study. BMC cardiovascular disorders, 12(1), 106. https://doi.org/10.1186/1471-2261-12-106

Gharahi, H., Zambrano, B. A., Zhu, D. C., DeMarco, J. K., & Baek, S. (2016). Computational fluid dynamic simulation of human carotid artery bifurcation based on anatomy and volumetric blood flow rate measured with magnetic resonance imaging. International journal of advances in engineering sciences and applied mathematics, 8(1), 46-60. https://doi.org/10.1007/s12572-016-0161-6

Gwunireama, I. U., Bob-Manuel, I. F., & Collins, G. U. (2023). A Study of Morphological Variations of Carotid Bifurcation and Branching Pattern of External Carotid Artery in Adult Nigerian Cadavers. Archives of Current Research International, 23(5), 40-48.

https://doi.org/10.9734/acri/2023/v23i5574

Ib, F. A., & Elghazaly, E. A. (2022). Variations of bifurcation of the common carotid artery, and origin of superior thyroid artery. Sudanese: A Cadaveric Study, SAR J Anat Physiol, 3(3), 22-26. https://doi.org/10.36346/sarjap.2022.v03i03.002

Kapre, M., Mangalgiri, A. S., & Mahore, D. (2013). Study of thyro-lingual trunk and its clinical relevance. Indian Journal of Otolaryngology and Head & Neck Surgery, 65(2), 102-104. https://doi.org/10.1007/s12070-011-0411-7

Liu, X., Guo, Y., Zhang, K., & Yu, J. (2024). Endovascular treatment of intracranial internal carotid artery bifurcation region aneurysms. Frontiers in Neurology, 15, 1344388. https://doi.org/10.3389/fneur.2024.1344388

Manisha, B. S., Naik, N., Sinha, H. P., Gautam, N., & Singh, P. (2019). Variation in common carotid artery bifurcation level: A computed tomographic study. Int J Sci Res, 8, 1-4.

Manokaran, A., Gaikwad, M. R., Gopalakrishnan, M., & Ravi, P. K. (2025). High Bifurcation of the Common Carotid Artery with Pentafurcation of the External Carotid Artery: Case Series with Review of Literature. Acta Medica Lituanica, 32(2), 404.

https://doi.org/10.15388/Amed.2025.32.2.12

Mina, V., Chrysikos, D., Troupis, T., & Filippou, D. (2025). Anatomical Variations of the Carotid Triangle: A Systematic Review. Cureus, 17(9), e91547. https://doi.org/10.7759/cureus.91547

Shreevastava, A. K., Das, R. S., Maheshwari, T. P., & Damodhar, B. K. (2022). Bilateral high trifurcation of the common carotid artery and variable emergence of the lower branches of the external carotid artery: a cadaveric case report. Cureus, 14(8), e27657. https://doi.org/10.7759/cureus.27657

Standring, S. (Ed.). (2021). Gray's Anatomy E-Book: Gray's Anatomy E-Book. Elsevier Health Sciences.

Szymańska, K., Pozowski, P., Misiak, P., Mazur, R., Silicki, J., Sierpowska, M., ... & Zaleska-Dorobisz, U. (2020). Trifurcation of the right common carotid artery-Case report. Radiology Case Reports, 15(6), 775-779. https://doi.org/10.1016/j.radcr.2020.03.011

Turfe, Z. A., Brinjikji, W., Murad, M. H., Lanzino, G., Cloft, H. J., & Kallmes, D. F. (2015). Endovascular coiling versus parent artery occlusion for treatment of cavernous carotid aneurysms: a meta-analysis. Journal of neurointerventional surgery, 7(4), 250-255.

https://doi.org/10.1136/neurintsurg-2014-011102

Xu, R., Yu, P., Liu, Y., Chen, G., Yang, Z., Zhang, Y., ... & Guo, Y. (2023). Climate change, environmental extremes, and human health in Australia: challenges, adaptation strategies, and policy gaps. The Lancet Regional Health-Western Pacific, 40

https://doi.org/10.1016/j.lanwpc.2023.100936

Zuin, M., Chatzizisis, Y. S., Beier, S., Shen, C., Colombo, A., & Rigatelli, G. (2023). Role of secondary flows in coronary artery bifurcations before and after stenting: What is known so far?. Cardiovascular Revascularization Medicine, 55, 83-87.

https://doi.org/10.1016/j.carrev.2023.06.018