4.7 Article

The Presence of Communicating Arteries in the Circle of Willis Is Associated with Higher Rate of Functional Recovery after Anterior Circulation Ischemic Stroke

相关参考文献

注意:仅列出部分参考文献,下载原文获取全部文献信息。
Article Anatomy & Morphology

Circle of Willis: anatomical variations of configuration. A magnetic resonance angiography study

M. Enyedi et al.

Summary: The aim of this study was to investigate the prevalence of anatomical variants of the circle of Willis (CoW) in the Romanian population through magnetic resonance angiography. A total of 126 individuals were included and the configurations of the anterior and posterior CoW were identified and classified. The study found that unilateral variations were the most common changes in the CoW configuration. The correct assessment of CoW configuration may be useful in surgical planning, follow-up, and prognosis estimation for patients with stroke or other related cerebral vascular events.

FOLIA MORPHOLOGICA (2023)

Article Clinical Neurology

Prognostic significance of blood pressure parameters after mechanical thrombectomy according to collateral status

Huaishun Wang et al.

Summary: Mechanical thrombectomy (MT) is an effective and safe therapy for acute ischemic stroke patients with large vessel occlusion. However, the post-procedural management, including blood pressure (BP), is still controversial. This study analyzed the association between blood pressure parameters and clinical outcomes in MT-treated stroke patients. The results showed that higher blood pressure variability (BPV) and shorter hypotension time were associated with poorer functional outcome and higher mortality at three months. Furthermore, the association between BPV and clinical prognosis was modified by the perception of ischemia time.

BMC NEUROLOGY (2023)

Review Clinical Neurology

Collateral Circulation in Ischemic Stroke: An Updated Review

Gino Maguida et al.

Summary: The collateral circulation is important in ischemic stroke as it maintains perfusion to brain tissue and allows for a longer time window for effective therapies. However, enhancing it as a therapeutic target remains a challenge. Assessment of the collateral circulation is now routine in neuroimaging for stroke, providing a more complete picture of the pathophysiology and aiding in treatment selection and outcome prediction. This review aims to provide an updated approach to the collateral circulation and highlight ongoing research with potential clinical applications.

JOURNAL OF STROKE (2023)

Article Neurosciences

Early Hemorrhagic Transformation after Reperfusion Therapy in Patients with Acute Ischemic Stroke: Analysis of Risk Factors and Predictors

Aida Iancu et al.

Summary: This study analyzed the risk factors and predictors of early hemorrhagic transformation (HT) after reperfusion therapy for acute ischemic stroke (AIS). The study found that male gender, baseline high blood pressure, high glycemic values, and higher values of NIHSS at 24 h were associated with an increased risk of early HT. These findings are important for determining the clinical outcome in AIS patients after reperfusion therapy.

BRAIN SCIENCES (2023)

Article Clinical Neurology

Effect of blood pressure on the prognosis of acute ischemic stroke patients caused by anterior circulation large vessel occlusion without recanalization

Tao Luo et al.

Summary: The study aimed to explore the influence of blood pressure on the prognosis of acute ischemic stroke patients caused by anterior circulation large vessel occlusion without recanalization. Retrospective analysis showed that the highest systolic blood pressure within 24 hours after admission was related to the prognosis. If the highest systolic blood pressure exceeded 180.5 mmHg, it would increase the risk of death.

CLINICAL NEUROLOGY AND NEUROSURGERY (2023)

Article Clinical Neurology

The influence of pre-reperfusion blood pressure on outcomes following mechanical thrombectomy for anterior circulation large vessel occlusion

Haydn Hoffman et al.

Summary: This study evaluated the impact of systolic blood pressure (SBP) and mean arterial pressure (MAP) parameters on functional status and intracranial hemorrhage (ICH) during the period between presentation and reperfusion in patients undergoing mechanical thrombectomy (MT). The results showed that higher pre-reperfusion SBP and greater variability in SBP during the thrombectomy procedure were associated with unfavorable functional status and ICH.

JOURNAL OF CLINICAL NEUROSCIENCE (2023)

Article Neuroimaging

Circle of Willis integrity in acute middle cerebral artery occlusion: does the posterior communicating artery matter?

Udi Sadeh-Gonik et al.

Summary: In patients with large vessel occlusion (LVO) and middle cerebral artery (MCA) occlusion undergoing endovascular thrombectomy (EVT), the anatomy of the circle of Willis (CW), particularly the posterior communicating artery (PComA) and the A1-portion of the anterior cerebral artery (A1-ACA), has a significant impact on stroke outcomes. A well-developed PComA is associated with lower rates of hemorrhagic transformation and better functional outcomes, and independently predicts survival.

JOURNAL OF NEUROINTERVENTIONAL SURGERY (2023)

Article Biology

Symptomatic Intracranial Hemorrhage after Ischemic Stroke Treated with Bridging Revascularization Therapy

Simon Amaral et al.

Summary: This study aimed to determine the frequency and factors contributing to symptomatic intracranial hemorrhage (sICH) in patients with ischemic stroke treated with bridging therapy. Results showed that 1 in 12 patients suffered sICH, which resulted in poor outcomes. Further studies are needed to identify high-risk patients and guide therapeutic strategies.

LIFE-BASEL (2023)

Article Clinical Neurology

Reclassifications of ischemic stroke patterns due to variants of the Circle of Willis

Ida Rangus et al.

Summary: Variants of the Circle of Willis (vCoW) are present in about one-third of stroke patients, more commonly in the posterior circulation. Reclassifications of stroke lesion patterns due to vCoW primarily occur in the posterior circulation, with fetal posterior cerebral artery mimicking multiple territory stroke pattern. Considering vCoW in these cases may uncover symptomatic carotid disease.

INTERNATIONAL JOURNAL OF STROKE (2022)

Review Clinical Neurology

Endovascular therapy for acute ischemic stroke: The importance of blood pressure control, sedation modality and anti-thrombotic management to improve functional outcomes

E. Robichon et al.

Summary: Endovascular therapy (EVT) following intravenous thrombolysis (IVT) is the standard treatment for acute ischemic stroke (AIS) patients with anterior large vessel occlusion (LVO). Factors such as blood pressure management, sedation modality, and anti-thrombotic strategy during and after EVT may affect the prognosis. Individualized blood pressure management based on baseline parameters could be a new approach. General anesthesia may lead to better functional outcomes and faster procedures. The use of new anti-thrombotic treatments during EVT is being investigated but further research is needed.

REVUE NEUROLOGIQUE (2022)

Article Clinical Neurology

Collateral Circulation in Thrombectomy for Stroke After 6 to 24 Hours in the DAWN Trial

David S. Liebeskind et al.

Summary: This study evaluated the impact of collaterals on outcomes in patients with cerebral ischemia and found that better collaterals led to slower progression of the disease and better functional outcomes.

STROKE (2022)

Review Clinical Neurology

Collateral Supply in Preclinical Cerebral Stroke Models

Philippe Bonnin et al.

Summary: Enhancing collateral blood supply during acute cerebral ischemia can limit infarct extension and reduce disability. Differences in collateral blood flow establishment time may vary between species and genetic backgrounds. Caution should be taken when translating preclinical findings to humans, and clinical trials are necessary to validate the added value of pharmacological agents for stimulating collateral blood supply.

TRANSLATIONAL STROKE RESEARCH (2022)

Article Developmental Biology

Anatomical study of circle of Willis on fresh autopsied brains. A study of a Romanian population

Ana Maria Dumitrescu et al.

Summary: The present study aimed to investigate the anatomical variants of the circle of Willis in the population of Northeastern Romania and found that these variants exhibited a high degree of polymorphism and distinct morphological features.

ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY (2022)

Article Radiology, Nuclear Medicine & Medical Imaging

Incomplete circle of Willis variants and stroke outcome

Eaton Lin et al.

Summary: This study suggests that the variants of the circle of Willis may be associated with a poorer prognosis for stroke patients.

EUROPEAN JOURNAL OF RADIOLOGY (2022)

Article Clinical Neurology

Association between blood pressure variability and clinical outcomes after successful recanalization in patients with large vessel occlusion stroke after mechanical thrombectomy

You Lu et al.

Summary: This study evaluated the influence of blood pressure variability on the clinical outcomes of stroke patients with large vessel occlusion who underwent successful recanalization. The study found that higher blood pressure variability was associated with worse functional outcomes, higher mortality rate, and increased risk of intracranial hemorrhage.

FRONTIERS IN NEUROLOGY (2022)

Editorial Material Clinical Neurology

Circle of Willis variants are not associated with thrombectomy outcomes

Thomas Seifert-Held et al.

Summary: This study showed that the completeness of the Circle of Willis was not predictive of functional outcome in patients after stroke at 90 days. However, there were significant associations with patients' baseline National Institutes of Health Stroke Scale, age, and reperfusion status. The study suggests that a larger cohort of over 3000 patients may reveal a significant association between an incomplete Circle of Willis and functional outcome at 90 days.

STROKE AND VASCULAR NEUROLOGY (2021)

Article Clinical Neurology

Association of Collateral Status and Ischemic Core Growth in Patients With Acute Ischemic Stroke

Longting Lin et al.

Summary: Collateral status is a major determinant of ischemic core growth, with better collaterals associated with slower core growth rate.

NEUROLOGY (2021)

Review Clinical Neurology

The core/penumbra model: implications for acute stroke treatment and patient selection in 2021

Jean-Claude Baron

Summary: Despite significant advances in prevention, ischaemic stroke remains a leading cause of death and disability globally. The discovery of salvaging ischaemic brain tissue known as the ischaemic penumbra has led to the development of highly efficient reperfusion therapies, changing the management of acute stroke patients. Individual physiology, along with time since stroke onset, should be considered for decision-making in optimizing patient selection for reperfusion therapies.

EUROPEAN JOURNAL OF NEUROLOGY (2021)

Article Clinical Neurology

Variants of the circle of Willis in ischemic stroke patients

Jolanda De Caro et al.

Summary: The study aimed to provide prevalence and pattern of anatomical variants of the circle of Willis in ischemic stroke patients and controls, and to determine their role in severity and prognosis. Results showed higher prevalence of variants in stroke patients, who were older but had similar outcomes compared to those with typical circle of Willis.

JOURNAL OF NEUROLOGY (2021)

Article Clinical Neurology

Circle of Willis variants and their association with outcome in patients with middle cerebral artery-M1-occlusion stroke

Laura P. Westphal et al.

Summary: 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.

EUROPEAN JOURNAL OF NEUROLOGY (2021)

Review Public, Environmental & Occupational Health

Distribution of variations in anatomy of the circle of Willis: results of a cadaveric study of the Malawian population and review of literature

Charles Nyasa et al.

Summary: The anatomical variations of the circle of Willis in Malawians appear to be distributed in similar frequencies and patterns as in other more diverse populations, including hypoplasia, aplasia, asymmetry, and accessory vessels, with a small percentage of typical circle of Willis. Three variants not previously described were also observed in this study, suggesting that these variations should be considered in clinical practice.

PAN AFRICAN MEDICAL JOURNAL (2021)

Article Neuroimaging

Greater infarct growth limiting effect of mechanical thrombectomy in stroke patients with poor collaterals

Arturo Renu et al.

JOURNAL OF NEUROINTERVENTIONAL SURGERY (2019)

Article Neurosciences

Metabolic Syndrome Is Associated with Intracranial Large Artery Disease among Ethnic Chinese Patients with Stroke

Deidre Anne De Silva et al.

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES (2009)

Article Clinical Neurology

Collateral Vessels on CT Angiography Predict Outcome in Acute Ischemic Stroke

Matthew B. Maas et al.

STROKE (2009)

Article Neurosciences

Collaterals in acute stroke: Beyond the clot

DS Liebeskind

NEUROIMAGING CLINICS OF NORTH AMERICA (2005)

Article Clinical Neurology

Collateral circulation

DS Liebeskind

STROKE (2003)