Morphologic Variations in the Circle of Willis as a Risk Factor for Aneurysm Rupture in the Anterior and Posterior Communicating Arteries

Oberman, Dan Zimelewicz; Akly, Manuel Sliman Perez; Rabelo, Ní­collas Nunes; Elizondo, Cristina; Corrêa, Jane; Ajler, Pablo; Baccanelli, Matteo

doi:10.1016/j.wneu.2021.06.151

Cited by 6 publications

(3 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The arteries that form this anastomotic circle may present variations in their geometry and symmetry and this may potentially generate changes in blood flow both in the anterior and posterior circulation. These hemodynamic alterations increase the stress on vessel walls, which in turn was demonstrated to be associated with the pathophysiology of IAs [3,26,27]. Tanaka et al [26] demonstrated in 125 subjects, using two-dimensional cine phase contrast MRI, that flow rates in both the carotid and basilar arteries were significantly different with the presence of circle of Willis variations.…”

Section: The Role Of Willis Circle Anomalies In Mca Aneurysm Developmentmentioning

confidence: 99%

“…Historically speaking, the first piece of evidence that there was a suspected association between anomalies in the circle of Willis and the incidence of aneurysms dates back a century ago [30][31][32][33]. Today, this relationship was successfully confirmed several times with ACom artery aneurysms [14][15][16][17]27,34,35], whereas relatively few reports exist regarding the association with those originating from MCA. In general, these aneurysms seem to develop more often in bifurcations with hypoplastic branches than in bifurcations with no hypoplastic branches.…”

Section: The Role Of Willis Circle Anomalies In Mca Aneurysm Developmentmentioning

confidence: 99%

See 1 more Smart Citation

Geometry and Symmetry of Willis’ Circle and Middle Cerebral Artery Aneurysms Development

Sturiale,

Scerrati,

Ricciardi

et al. 2024

JCM

View full text Add to dashboard Cite

Background: A relationship between the geometry and symmetry of Willis’ circle and intracranial aneurysms was reported for anterior communicating and posterior communicating (PCom) aneurysms. A similar association with the middle cerebral artery (MCA) aneurysms instead appeared weaker. Methods: We reviewed 432 patients from six Italian centers with unilateral MCA aneurysms, analyzing the relationship between the caliber and symmetry of Willis’ circle and the presence of ruptured and unruptured presentation. CT-angiograms were evaluated to assess Willis’ circle geometrical characteristics and the MCA aneurysm side, dimension and rupture status. Results: The hypoplasia of the first segment of the anterior cerebral artery (A1) was in approximately one-quarter of patients and PCom hypoplasia was in almost 40%. About 9% had a fetal PCom ipsilaterally to the aneurysm. By comparing the aneurysmal and healthy sides, only the PCom hypoplasia appeared significantly higher in the affected side. Finally, the caliber of the internal carotid artery (ICA) and the first segment of MCA (M1) caliber were significantly greater in patients with unruptured aneurysms, and PCom hypoplasia appeared related to the incidence of an ipsilateral MCA aneurysm and its risk of rupture. Conclusions: Although according to these findings asymmetries of Willis’ circle are shown to be a risk factor for MCA aneurysm formation and rupture, the indifferent association with ipsilateral or contralateral hypoplasia remains a datum of difficult hemodynamic interpretation, thereby raising the concern that this association may be more casual than causal.

show abstract

Section: The Role Of Willis Circle Anomalies In Mca Aneurysm Developmentmentioning

confidence: 99%

Section: The Role Of Willis Circle Anomalies In Mca Aneurysm Developmentmentioning

confidence: 99%

Geometry and Symmetry of Willis’ Circle and Middle Cerebral Artery Aneurysms Development

Sturiale,

Scerrati,

Ricciardi

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

“…In the textbook, its anatomy is characterized by a symmetrical polygon of anterior and posterior circulation linked by connecting arteries, which provides several pathways for collateral blood flow to the brain (2). In patients without a history of cerebrovascular disease, incomplete circle of Willis (CoW) is related to the occurrence of circulation stroke, development of cerebral aneurysms, and their rupture in the future CoW (3)(4)(5). There is limited research in this area, especially in my country, Vietnam, although the CoW structure varied by ethnicity, and a survey of CoW revealed a fluctuating rate of variable completeness incidence (6,7).…”

Section: Introductionmentioning

confidence: 99%

The Variations in the Circle of Willis on 64-Multislice Spiral Computed Tomography

et al. 2022

View full text Add to dashboard Cite

Background: The circle of Willis is an anastomotic network of arteries surrounding the base of the brain. People with effective collateral circulation will lower the risk of transient ischemic attack and stroke than those with ineffective collaterals. Objectives: The research aims to study the diameter of arteries and determine the frequency and patterns of anatomical variations in Vietnamese patients' anterior and posterior parts of the Willis polygon. Methods: This descriptive cross-sectional study was conducted in Vietnam at Bach Mai hospital between July 2010 and July 2011. A total of 102 MSCT 64 examinations were conducted on adult patients with suspected cerebrovascular diseases such as stroke, cerebral infarction, etc. The average internal diameter of arteries was estimated using descriptive statistics. Wilcoxon signed-rank test paired t-test to compare diameter on the left and right sides. Results: There are four types of anterior parts and twelve types of posterior parts in the circle of Willis. Of the 102 subjects, 29.41% experienced the anterior part of circle of Willis (CoW), in which aplastic anterior communicating artery (ACoA) is the most common type (21.57%). 70.59% of all subjects have variations in the posterior part of CoW, and bilateral aplastic posterior communicating artery (PCoA) is the most common type (20.59%). We also report the diameter of cerebral artery segments of the circle of Willis. There are six variations in the circle of Willis based on the correlation between pre communicating part P1 of posterior cerebral artery (PCA) (P1) and PCoA diameter. The most popular type is adult configuration (53.92%). Conclusions: We provided the prevalence and the pattern of the brain vascular variants of the circle of Willis in a group of patients diagnosed with ischemic stroke. Understanding the variations and diameter of the circle of Willis is of great importance in interventional radiology for various endovascular interventions in Vietnamese patients.

show abstract

Fetal-type posterior cerebral artery and association of rupture in posterior communicating artery aneurysms: A systematic review and meta-analysis

Arrambide-Garza

Álvarez-Lozada

León-Gutiérrez

et al. 2023

Clinical Neurology and Neurosurgery

View full text Add to dashboard Cite

Morphologic Variations in the Circle of Willis as a Risk Factor for Aneurysm Rupture in the Anterior and Posterior Communicating Arteries

Cited by 6 publications

References 60 publications

Geometry and Symmetry of Willis’ Circle and Middle Cerebral Artery Aneurysms Development

Geometry and Symmetry of Willis’ Circle and Middle Cerebral Artery Aneurysms Development

The Variations in the Circle of Willis on 64-Multislice Spiral Computed Tomography

Fetal-type posterior cerebral artery and association of rupture in posterior communicating artery aneurysms: A systematic review and meta-analysis

Contact Info

Product

Resources

About