Cerebral Collateral Circulation in Carotid Artery Disease

Romero, José R.; Pikula, Aleksandra; Nguyen, Thanh N.; Nien, Yih Lin; Norbash, Alexander; Babikian, Viken L.

doi:10.2174/157340309789317887

Cited by 97 publications

(71 citation statements)

References 58 publications

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“…In patients with carotid atherosclerosis, the risk of stroke is altered by the presence of collateral circulation and by the varying demographic properties of the patients 2 . The incidence of stroke in patients with asymptomatic and symptomatic internal carotid artery stenosis is 1, 2-5, 9% and 10% respectively 1 .…”

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The association of the circle of Willis anomaly and risk of stroke in patients with carotid artery disease

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Kucukseymen

et al. 2017

Arq. Neuro-Psiquiatr.

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Extracranial atherosclerotic disease accounts for 15-20% of all ischemic strokes 1 . In patients with carotid atherosclerosis, the risk of stroke is altered by the presence of collateral circulation and by the varying demographic properties of the patients 2 . The incidence of stroke in patients with asymptomatic and symptomatic internal carotid artery stenosis is 1, 2-5, 9% and 10% respectively 1 . The protective role of collateral circulation depends on many factors such as anatomic variations, systemic arterial pressure, age and the progression rate of the occlusive disease. The mainstay of collateral circulation is the circle of Willis and, in the case of a large artery occlusion, it is readily available to restore the perfusion. The anatomic properties of the collateral circulation may determine the subtypes of stroke in patients with occlusive carotid artery disease. In a previous study, up to 50% of anatomical variations in the cerebral collateral of patients were detected in the circle of Willis 2 . In patients with symptomatic carotid artery stenosis, reduction of blood flow due to a stenotic carotid artery is compensated by the increased blood flow of the collateral system 3 . The circle of Willis is an important collateral pathway, as it can maintain blood flow from the contralateral carotid and basilar artery to the stenotic carotid artery region. In a study of patients with symptomatic carotid artery disease, ABSTRACTThe 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.Keywords: circle of Willis; carotid artery diseases; stroke; angiography. 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 demográ...

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confidence: 99%

The association of the circle of Willis anomaly and risk of stroke in patients with carotid artery disease

Göksu

Koç

Kucukseymen

et al. 2017

Arq. Neuro-Psiquiatr.

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“…If there is a hypoplasia in the CoW, the collateral flow may happen not only in the main but also in the secondary cerebral collateral networks, furthermore angiogenesis may also happen in the posterior part to maintain the blood flow supplied to the PCA region [15][16][17]. The CoW which constitutes the main cerebral collateral network was constructed in our 1D model as shown in Fig.…”

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Development of patient-specific 1D-0D simulation based on MRI and SPECT data

et al. 2018

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The hemodynamics of blood flow in the Circle of Willis (CoW) is considered to be important for the understanding of disease progression in cerebral circulation. In this research, we developed a method by combining 1D-0D model with the medical imaging data of magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT), in order to investigate the hemodynamics in CoW. The MRI data was used as the arterial geometry parameter for 1D model. The SPECT data was used as the reference data for the flow rates at the efferent arteries of CoW, which indicated if adjustment needed to be made to the peripheral cerebral resistance for 0D model. We applied our method to two patients and compared the simulation results with PC-MRI measurement data. The comparison showed the differences of flow distribution in the afferent arteries between simulation results and measurement data were 0.6-6.0% and 5.7-13.2% respectively in two cases. Both simulations captured the individual difference of flow distribution in the CoW. The results suggested that our method can be used to obtain the hemodynamics information in the CoW for an individual patient.

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“…İnme geliştiğinde kolletaral dolaşım infarktın dağılımına ve şiddetine önemli ölçüde etkide bulunmaktadır. Kolletarallerin durumuna göre infarkt watershead olmakta ya da bir damar sulama alanını tutabilmektedir (4,14). Önemli bir parçasını WP'nun oluşturduğu primer serebral kollateral dolaşım beyin damar tıkanıklığı durumunda 1-4dk gibi kısa bir sürede devreye girerek serebral perfüzyonun sağlıklı bir şekilde devam ettirilmesini sağlayabilir.…”

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