期刊
EUROPEAN JOURNAL OF NEUROLOGY
卷 28, 期 11, 页码 3682-3691出版社
WILEY
DOI: 10.1111/ene.15013
关键词
anatomical variants; circle of Willis; collaterals; stroke; TOF-MRA
资金
- UZH Clinical Research Priority Program (CRPP) stroke
- Swiss National Science Foundation [SNSF PP00P3_170683]
The study found no evidence of an association between Circle of Willis variants and clinical outcomes in LVO stroke patients undergoing EVT. However, there were trends towards higher mortality in patients with any type of CoW variant, particularly among those with incomplete CoW who died within 3 months after stroke onset.
Background An incomplete circle of Willis (CoW) has been associated with a higher risk of stroke and might affect collateral flow in large vessel occlusion (LVO) stroke. We aimed to investigate the distribution of CoW variants in a LVO stroke and transient ischemic attack (TIA) cohort and analyze their impact on 3-month functional outcome. Methods CoW anatomy was assessed with time-of-flight magnetic resonance angiography (TOF-MRA) in 193 stroke patients with acute middle cerebral artery (MCA)-M1-occlusion receiving endovascular treatment (EVT) and 73 TIA patients without LVO. The main CoW variants were categorized into four vascular models of presumed collateral flow via the CoW. Results 82.4% (n = 159) of stroke and 72.6% (n = 53) of TIA patients had an incomplete CoW. Most variants affected the posterior circulation (stroke: 77.2%, n = 149; TIA: 58.9%, n = 43; p = 0.004). Initial stroke severity defined by the National Institutes of Health Stroke Scale (NIHSS) on admission was similar for patients with and without CoW variants. CoW integrity did not differ between groups with favorable (modified Rankin Scale [mRS]): 0-2) and unfavorable (mRS: 3-6) 3-month outcome. However, we found trends towards a higher mortality in patients with any type of CoW variant (p = 0.08) and a higher frequency of incomplete CoW among patients dying within 3 months after stroke onset (p = 0.119). In a logistic regression analysis adjusted for the potential confounders age, sex and atrial fibrillation, neither the vascular models nor anterior or posterior variants were independently associated with outcome. Conclusion Our data provide no evidence for an association of CoW variants with clinical outcome in LVO stroke patients receiving EVT.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据