Noninvasive assessment of cerebral collateral blood supply through the ophthalmic artery.

Schneider, Peter A.; Rossman, M E; Bernstein, Eugene F.; Ringelstein, E B; Otis, Shirley M.

doi:10.1161/01.str.22.1.31

Cited by 65 publications

(39 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, some have suggested that the OphA does have a functional contribution to cerebral circulation. 24 A decrease in collateral flow via the OphA would then indicate a worsening of blood supply to the brain. Based on our study, we cannot discriminate between the 2 interpretations.…”

Section: Discussionmentioning

confidence: 99%

A Longitudinal Study of Collateral Flow Patterns in the Circle of Willis and the Ophthalmic Artery in Patients With a Symptomatic Internal Carotid Artery Occlusion

Rutgers

Klijn

Kappelle

et al. 2000

Stroke

View full text Add to dashboard Cite

Background and Purpose-The purpose of the present study was to assess whether the direction of flow via the circle of Willis and the ophthalmic artery (OphA) changed over time in patients with a symptomatic occlusion of the internal carotid artery (ICA) who did not experience recurrent cerebral ischemic symptoms. Methods-Sixty-two patients with a symptomatic ICA occlusion were investigated within 6 months after symptoms occurred. The investigations were repeated after 6 and 12 months. The directions of flow in the A1 segment and the posterior communicating artery (PCoA), both on the side of the symptomatic ICA occlusion, were assessed with the use of magnetic resonance angiography. The pattern of collateral flow via the circle of Willis was categorized as via the A1 segment only, via the PCoA only, via the A1 segment plus the PCoA, or no collateral flow via the circle of Willis. The direction of flow in the OphA was investigated with transcranial Doppler sonography. CO 2 reactivity was determined with transcranial Doppler sonography to investigate whether changes in flow patterns were accompanied by changes in cerebrovascular reactivity. Results-There were no statistically significant changes over time in the direction of blood flow in the A1 segment and the PCoA or in the pattern of collateral flow via the circle of Willis. On average, 72% of patients with a unilateral ICA occlusion (nϭ41) had willisian collateral flow compared with 37% of patients with a bilateral ICA occlusion (nϭ21; PϽ0.05). Patients with a unilateral ICA occlusion tended to a lower prevalence of reversed flow via the OphA over time. CO 2 reactivity did not change significantly in any patient group. In patients with a unilateral ICA occlusion, decreased CO 2 reactivity was associated with a higher prevalence of absent willisian collateral flow and a lower prevalence of collateral flow via the A1 segment plus the PCoA. Conclusions-The absence of recurrent cerebral ischemic symptoms in patients with a symptomatic ICA occlusion is not associated with an improvement in collateral flow via the circle of Willis or the OphA during 1.5-year follow-up.

show abstract

Section: Discussionmentioning

confidence: 99%

A Longitudinal Study of Collateral Flow Patterns in the Circle of Willis and the Ophthalmic Artery in Patients With a Symptomatic Internal Carotid Artery Occlusion

Rutgers

Klijn

Kappelle

et al. 2000

Stroke

View full text Add to dashboard Cite

show abstract

“…In cases and controls with ICA occlusion, we assessed this type of collateral flow by means of a 7.5-MHz probe which was placed over the orbit using coupling gel, with the eyelid closed [30]. To prevent damage to the retina, the Doppler power was always reduced to 10% of that required to penetrate the temporal bone.…”

Section: Methodsmentioning

confidence: 99%

Absent Collateral Function of the Circle of Willis as Risk Factor for Ischemic Stroke

et al. 2003

View full text Add to dashboard Cite

Background: Autopsy studies show a higher prevalence of circle of Willis anomalies in brains with signs of ischemic infarction. Our goal was to examine the collateral function of the circle of Willis in ischemic stroke patients and to assess in a case-control study if a collateral deficient circle of Willis is a risk factor for ischemic stroke in patients with severe internal carotid artery (ICA) occlusive disease. Methods: Our case-control study included 109 patients with an acute ischemic stroke in the anterior circulation and 113 patients with peripheral arterial disease and no known history of cerebral ischemia. The collateral function of the anterior and posterior communicating arteries of the circle of Willis was assessed by means of transcranial color-coded duplex ultrasonography (TCCD) and carotid compression tests. Results: TCCD was successfully performed in 75 case patients (mean age 64 years, range 41–91 years) and in 100 control patients (mean age 61 years, range 35–89 years). In 26 cases and 19 controls, a ≧70% stenosis or occlusion of the ICA was found. A nonfunctional anterior collateral pathway in the circle of Willis was found in 33% of the cases and in 6% of the controls (p < 0.001). The posterior collateral pathway was nonfunctional in 57% of the cases and in 43% of the controls (p = 0.02). In patients with severe ICA occlusive disease, the odds ratios of a nonfunctional anterior and a nonfunctional posterior collateral pathway were 7.33 (95% confidence interval, CI, = 1.19–76.52) and 3.00 (95% CI = 0.77–12.04), respectively. Conclusions: Patients who suffer ischemic stroke in the anterior circulation have a higher incidence of collateral deficient circles of Willis than those with atherosclerotic vascular disease without ischemic cerebrovascular disease. The presence of a nonfunctional anterior collateral pathway in the circle of Willis in patients with severe ICA occlusive disease is strongly associated with ischemic stroke.

show abstract

“…However, its role in cerebral collateralization is somewhat controversial [9][10][11][12][13][14][15][16][17][18]. The ophthalmic artery (OA) is traditionally regarded as an important source of cerebral blood supply in patients with ICA occlusion [10,11].…”

Section: Introductionmentioning

confidence: 99%

Reversal of ophthalmic artery blood flow direction and severe ipsilateral carotid stenosis

Grilo¹,

Monteiro²,

Santos³

et al. 2014

IJCNMH

View full text Add to dashboard Cite

Background: The assessment of ophthalmic artery flow direction by transcranial Doppler sonography has become part of the cerebrovascular routine examination in stroke patients. It provides helpful information for the investigation of collateral circulation and can evaluate the hemodynamic significance of high-grade internal carotid artery (ICA) stenosis. Our aim was to determine the value of assessing the direction of ophthalmic artery blood flow in the setting of routine color flow duplex ultrasonography examination of patients with ipsilateral carotid disease.

show abstract

Noninvasive assessment of cerebral collateral blood supply through the ophthalmic artery.

Cited by 65 publications

References 18 publications

A Longitudinal Study of Collateral Flow Patterns in the Circle of Willis and the Ophthalmic Artery in Patients With a Symptomatic Internal Carotid Artery Occlusion

A Longitudinal Study of Collateral Flow Patterns in the Circle of Willis and the Ophthalmic Artery in Patients With a Symptomatic Internal Carotid Artery Occlusion

Absent Collateral Function of the Circle of Willis as Risk Factor for Ischemic Stroke

Reversal of ophthalmic artery blood flow direction and severe ipsilateral carotid stenosis

Contact Info

Product

Resources

About