Study on the correlation between the circle of Willis structure and collateral circulation in bilateral carotid artery occlusion

被引:11
|
作者
Liu, Yang [1 ]
Zhu, Lei [2 ]
Hou, Bei [3 ]
Wang, Tuoyi [4 ]
Xu, Dechao [1 ]
Tan, Chenxi [1 ]
Zhang, Huiyi [1 ]
Li, Chunyan [5 ]
Wang, Jianan [2 ]
机构
[1] Qiqihar Med Univ, Affiliated Hosp 2, Dept Neurol, 37 West Zhonghua Rd, Qiqihar 161006, Heilongjiang, Peoples R China
[2] PLA Rocket Force Characterist Med Ctr, Dept Nucleus Radiat Related Injury Treatment, 16 Xinjiekouwai St, Beijing 100088, Peoples R China
[3] PLA Rocket Force Characterist Med Ctr, Dept Urol, 16 Xinjiekouwai St, Beijing 100088, Peoples R China
[4] Qiqihar Univ, Coll Food & Biol Engn, 42 Wenhua St, Qiqihar 161006, Heilongjiang, Peoples R China
[5] Qiqihar Med Univ, Ctr Pathol, 333 North Bukui Rd, Qiqihar 161006, Heilongjiang, Peoples R China
关键词
Circle of Willis; Carotid stenosis; occlusion; Collateral circulation; Blood stealing;
D O I
10.1007/s10072-021-05265-4
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and purpose Bilateral carotid artery occlusion (CAO) is a rare condition and the collateral circulation is more complicated than in unilateral CAO. The circle of Willis (CoW) is the most important collateral circulation compensation pathway in CAO. However, the specific role of CoW in the collateral circulation compensation pathway of CAO has not been fully elucidated. The purpose of this study is to investigate the role of CoW in the collateral circulation compensation pathway of CAO. Materials and methods Clinical, imaging, and hemodynamic data of 30 patients with bilateral CAO were collected to analyze the collateral blood flow compensation pathway and its characteristics, and to examine the correlation between the structure of the CoW and the collateral circulation of bilateral CAO. Results This paper summarized 30 patients with bilateral CAO. There were 0 cases of the CoW complete type, 18 cases of the partially complete type (60%), and 12 cases of the incomplete type (40%). For the partially complete type cases, there were 14 complete anterior circulation cases (46.7%). The collateral circulation collateral circulation pathway included 14 cases with anterior communicating artery(ACoA), 7 cases with posterior cerebral artery (PCA)-middle cerebral artery (MCA) leptomeningeal anastomosis (LMA), 5 cases with ophthalmic artery(OA), 3 cases with lateral posterior communicating artery(PCoA), 1 case with internal carotid artery (ICA) stealing, 1 case with new Moyamoya vessels, and 4 cases of other types. There were four cases (13.3%) with complete posterior circulation, including four cases with bilateral PCoA, three cases with PCA-MCA LMA, and two cases with OA. There were 12 cases (40%) with incomplete CoW, including 8 cases with PCA-MCA LMA, 3 cases with lateral PCoA, 1 case with anterior cerebral artery (ACA)-MCA LMA, 4 cases with OA, and 1 other case. Conclusion The collateral circulation pathway differs among patients with different CoW structure types. When the CoW is partially complete, it mainly provides blood flow compensation to the ischemic area through primary collateral circulation. When the CoW is incomplete, it mainly provides blood flow compensation to the ischemic area through secondary collateral circulation.
引用
收藏
页码:5335 / 5342
页数:8
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