{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:52:42Z","timestamp":1791474762400,"version":"4.3.4"},"reference-count":84,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T00:00:00Z","timestamp":1766793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T00:00:00Z","timestamp":1766793600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>A retropharyngeal internal carotid artery (RP\u2010ICA) is a cervical ICA variant that courses adjacent to or abuts the pharyngeal wall, reducing the safety margin during procedures such as nasotracheal intubation and transoral surgery. Although described for over a century, relatively few cohort studies have investigated its prevalence, and no pooled estimate has been established. Following PRISMA guidelines, we systematically searched PubMed, Embase, Scopus, Web of Science, and Google Scholar (as of August 2025) for adult imaging cohorts that reported both the numerator (RP\u2010ICA cases) and the denominator. Two reviewers independently performed study screening and data extraction. Exclusion criteria included non\u2010ICA vascular variants, studies of low quality, those written in languages other than English, and those with unavailable full text. The risk of bias was assessed using a modified Newcastle\u2013Ottawa Scale. Study\u2010specific proportions were logit\u2010transformed and pooled using a DerSimonian\u2013Laird random\u2010effects model with 95% confidence intervals (CI). Of 743 records identified, 595 titles\/abstracts were screened and 89 full texts assessed; 47 studies were included qualitatively, and five imaging cohorts were meta\u2010analyzed. Across these cohorts, 150 RP\u2010ICA cases were identified among 10,066 adults. Prevalence in individual studies ranged from 0.07% to 7.97%. The pooled prevalence was 1.51% (95% CI, 0.53%\u20134.21%), with substantial heterogeneity. The oropharynx was the most frequent site of RP\u2010ICA. Several reports described carotid arteries within a few millimeters of the pharyngeal mucosa or in direct contact, and positional changes were observed on serial imaging. The qualitative synthesis detailed pharyngeal level, laterality, and carotid\u2013pharyngeal distances. Original imaging evidence of cases involving multiple RP\u2010ICAs and additional carotid segments was further reported. RP\u2010ICA is an uncommon but clinically significant vascular variant. Standardized reporting of minimum carotid\u2013pharyngeal distance, pharyngeal level, laterality, and core imaging parameters would enhance comparability across studies and facilitate risk communication in otolaryngology, anesthesia, dentistry, vascular surgery, and spine surgery.<\/jats:p>","DOI":"10.1002\/ca.70072","type":"journal-article","created":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T19:15:25Z","timestamp":1766862925000},"page":"931-948","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Retropharyngeal Internal Carotid Artery: A Systematic Review, Meta\u2010Analysis of the Current Literature, and Evidence Sampling"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4655-4574","authenticated-orcid":false,"given":"R\u0103zvan Costin","family":"Tudose","sequence":"first","affiliation":[{"name":"Division of Anatomy, Department 1, Faculty of Dentistry \u201cCarol Davila\u201d University of Medicine and Pharmacy  Bucharest Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei Darius","family":"Stan","sequence":"additional","affiliation":[{"name":"Division of Anatomy, Department 1, Faculty of Dentistry \u201cCarol Davila\u201d University of Medicine and Pharmacy  Bucharest Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8196-9782","authenticated-orcid":false,"given":"Alexandra Diana","family":"Vrapciu","sequence":"additional","affiliation":[{"name":"Division of Anatomy, Department 1, Faculty of Dentistry \u201cCarol Davila\u201d University of Medicine and Pharmacy  Bucharest Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1464-5021","authenticated-orcid":false,"given":"Ionu\u021b M\u0103d\u0103lin","family":"Munteanu","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases of Timi\u015foara, Clinic of Anesthesia and Intensive Care \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy Timi\u015foara  Timi\u015foara Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1302-580X","authenticated-orcid":false,"given":"C\u0103t\u0103lin Constantin","family":"Dumitru","sequence":"additional","affiliation":[{"name":"Division of Anatomy, Department 1, Faculty of Dentistry \u201cCarol Davila\u201d University of Medicine and Pharmacy  Bucharest Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0122-2436","authenticated-orcid":false,"given":"George","family":"Triantafyllou","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences National and Kapodistrian University of Athens  Athens 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