The role of the circle of willis in carotid occlusion: Assessment with phase contrast MR angiography and transcranial duplex

Miralles, Manuel; Dolz, J.L.; Cotillas, J.; Aldoma, J.; Santiso, Mercedes; Giménez, Alfonsina; Capdevila, Antonio; Cairols, Marc

doi:10.1016/s1078-5884(05)80164-9

Cited by 95 publications

(80 citation statements)

References 21 publications

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“…Previous studies have suggested that the ACoA is a more important collateral pathway than collateral flow via the PCoA to maintain normal cerebral hemodynamics. 13,37,38 Computerized flow prediction models indicated that the ACoA is the major conduit of collateral blood supply, whereas the PCoA is presumed to be more important as source of collateral flow in patients with a small ACoA. 39 -41 Compared with control subjects, we found a significantly increased prevalence (65%) of collateral flow via the A1 segment, which is in accord with the prevalences described in the literature that varied between 46% and 80%.…”

Section: Discussionsupporting

confidence: 85%

Collateral Ability of the Circle of Willis in Patients With Unilateral Internal Carotid Artery Occlusion

Hendrikse

Hartkamp

Hillen

et al. 2001

Stroke

134

108

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Background and Purpose-The circle of Willis is regarded as the major source of collateral flow in patients with severe carotid artery disease. The purpose of the present study was to assess whether the presence of border zone infarcts is related to the collateral ability of the circle of Willis in symptomatic (transient ischemic attack, minor stroke) and asymptomatic patients with unilateral occlusion of the internal carotid artery (ICA). Methods-Fifty-one patients (35 symptomatic, 16 asymptomatic) and 53 control subjects were investigated. Patients had unilateral occlusion of the ICA and contralateral ICA stenosis between 0% and 69%.

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Section: Discussionsupporting

confidence: 85%

Collateral Ability of the Circle of Willis in Patients With Unilateral Internal Carotid Artery Occlusion

Hendrikse

Hartkamp

Hillen

et al. 2001

Stroke

134

108

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“…Clinically, the using of Transcranial Doppler (TCD) [9][10][11][12][13][14][15][16][17][18][19][20], Magnetic Resonance Angiography (MRA) [13,15,17,19,[21][22][23][24][25][26] and Computed Tomography Angiography (CTA) [22,[27][28][29] provide the in-vivo perspective of the role of the CoW in the collateral flow in anatomical variations. Numerically, one-dimensional [30][31][32][33][34][35][36], two-dimensional [37,38] and threedimensional [31,34,[39][40][41][42][43] models of the CoW were developed, flows in the CoW with common anatomical variations were investigated.…”

Section: Introductionmentioning

confidence: 99%

Experimental Study of Hemodynamics in the Circle of Willis

Zhu

Yuan

Yeo

2013

Volume 1A: Abdominal Aortic Aneurysms; Active and Reactive Soft Matter; Atherosclerosis; BioFluid Mechanics; Education; Biotran

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“…2 The anterior and posterior communicating arteries (ACoA and PCoA, respectively) are considered the primary collateral pathways in patients with an ICA occlusion. 3,4 Hypothetically, preferential flow patterns may develop, such as the presence of collateral flow via the ACoA, [5][6][7] the PCoA, 4,7 or both the ACoA and PCoA. 8,9 Accordingly, the time course of flow in the ophthalmic artery (OphA), which is regarded a secondary collateral pathway in patients with an ICA occlusion, 3,4 is a matter of interest.…”

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confidence: 99%

“…Magnetic resonance angiography (MRA) has proved to be a valuable technique for the study of flow in the circle of Willis in patients with an ICA occlusion, 4,5,10,11 whereas flow in the OphA can be reliably assessed with transcranial Doppler sonography (TCD). 11,12 In addition, we investigated whether changes in flow patterns were accompanied by changes in cerebrovascular reactivity as assessed with TCD.…”

mentioning

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

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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.

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The role of the circle of willis in carotid occlusion: Assessment with phase contrast MR angiography and transcranial duplex

Cited by 95 publications

References 21 publications

Collateral Ability of the Circle of Willis in Patients With Unilateral Internal Carotid Artery Occlusion

Collateral Ability of the Circle of Willis in Patients With Unilateral Internal Carotid Artery Occlusion

Experimental Study of Hemodynamics in the Circle of Willis

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

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