Subscribe to RSS
DOI: 10.1590/0004-282X20170054
The association of the circle of Willis anomaly and risk of stroke in patients with carotid artery disease
A associação de anomalia de Círculo de Willis e o risco de AVC em pacientes com doença carotídea
ABSTRACT
The circle of Willis is an important collateral system that maintains perfusion to the stenotic area from the contralateral carotid and basilar artery to the region of reduced brain perfusion. The aim of the present study was to compare the circle of Willis anomaly in patients with unilateral symptomatic and asymptomatic carotid artery disease.
Results
In this retrospective study, we analyzed 175 patients who presented at our outpatient stroke clinic between January, 2013 and June, 2015 with either unilateral symptomatic or asymptomatic carotid artery disease, and who had had CT angiography imaging performed. Demographic properties, carotid artery stenosis and the anomaly of the circle of Willis was recorded.
Conclusion
There was no statistically significant difference in patients with symptomatic and asymptomatic carotid artery disease in terms of the anomaly of the circle of Willis.
RESUMO
O Círculo de Willis é um importante sistema colateral que mantém a perfusão à área estenótica da carótida contralateral e da artéria basilar para a região de perfusão cerebral reduzida. O objetivo do presente estudo foi comparar a anomalia do Círculo de Willis em pacientes com doença carotídea assintomática e sintomática unilateral.
Resultados
Neste estudo retrospectivo, foram analisados 175 pacientes que foram à nossa clínica ambulatorial de AVC, entre janeiro de 2013 e junho de 2015, com doença carotídea assintomática ou sintomática unilateral, e que fizeram angiografia por tomografia computadorizada. Propriedades demográficas, estenose da artéria carótida e anomalia do Círculo de Willis foram registradas.
Conclusão
Não houve diferença estatisticamente significativa em pacientes com doença carotídea sintomática e assintomática em termos de anomalia do Círculo de Willis.
Publication History
Received: 18 July 2016
Accepted: 14 February 2017
Article published online:
05 September 2023
© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Gupta A, Chazen JL, Hartman M, Delgado D, Anumula N, Shao H et al. Cerebrovascular reserve and stroke risk in patients with carotid stenosis or occlusion: a systematic review and meta-analysis. Stroke. 2012;43(11):2884-91. https://doi.org/10.1161/STROKEAHA.112.663716
- 2 Romero JR, Pikula A, Nguyen TN, Nien YL, Norbash A, Babikian VL. Cerebral collateral circulation in carotid artery disease. Curr Cardiol Rev. 2009;5(4):279-88. https://doi.org/10.2174/157340309789317887
- 3 Waaijer A, Leeuwen MS, Worp HB, Verhagen HJ, Mali WP, Velthuis BK. Anatomic variations in the circle of Willis in patients with symptomatic carotid artery stenosis assessed with multidetector row CT angiography. Cerebrovasc Dis. 2007;23(4):267-74. https://doi.org/10.1159/000098326
- 4 Henderson RD, Eliasziw M, Fox AJ, Rothwell PM, Barnett HJ. Angiographically defined collateral circulation and risk of stroke in patients with severe carotid artery stenosis. Stroke. 2000;31(1):128-32. https://doi.org/10.1161/01.STR.31.1.128
- 5 North American Symptomatic Carotid Endarterectomy Trial (NASCET) investigators. Clinical alert: benefit of carotid endarterectomy for patients with high-grade stenosis of the internal carotid artery. Stroke. 1991;22(6):816-7. https://doi.org/10.1161/01.STR.22.6.816
- 6 Hoksbergen AW, Legemate DA, Csiba L, Csáti G, Síró P, Fülesdi B et al. Absent collateral function of the circle of Willis as risk factor for ischemic stroke. Cerebrovasc Dis. 2003;16(3):191-8. https://doi.org/10.1159/000071115
- 7 Bozzao A, Floris R, Gaudiello F, Finocchi V, Fantozzi LM, Simonetti G. Hemodynamic modifications in patients with symptomatic unilateral stenosis of the internal carotid artery: evaluation with MR imaging perfusion sequences. AJNR Am J Neuroradiol. 2002;23(8):1342-5.
- 8 Hartkamp MJ, Der Grond JV, Everdingen KJ, Hillen B, Mali WP. Circle of Willis collateral flow investigated by magnetic resonance angiography .Stroke. 1999;30(12)2671-8. https://doi.org/10.1161/01.STR.30.12.2671
- 9 Kamışlı S, Kamışlı Ö, Teker U, Kablan Y, Saraç K, Özcan C. [Circle of Willis anomalies in stroke patients related with symptomatic carotid artery disease]. Turkish J Cerebrovasc Dis. 2012;18(1):6-9. Turkish https://doi.org/10.5505/tbdhd.2012.36844
- 10 Shaban A, Albright K, Gouse B, George A, Monlezun D, Boehme A et al. The impact of absent A1 segment on ischemic stroke characteristics and outcomes. J Stroke Cerebrovasc Dis. 2015;24(1):171-5. https://doi.org/10.5505/tbdhd.2012.36844
- 11 Chuang YM, Liu CY, Pan PJ, Lin CP. Anterior cerebral artery A1 segment hypoplasia may contribute to A1 hypoplasia syndrome. Eur Neurol. 2007;57(4):208-11. https://doi.org/10.1159/000099160
- 12 Hendrikse J, Hartkamp MJ, Hillen B, Mali WP, Grond J. Collateral ability of the circle of Willis in patients with unilateral internal carotid artery occlusion: border zone infarcts and clinical symptoms. Stroke. 2001;32(12):2768-73. https://doi.org/10.1161/hs1201.099892