Preoperative evaluation of patients with extracranial carotid disease. Plethysmographic criteria for the use of a shunt, and for avoidance of surgery
3
Citation
27
Reference
10
Related Paper
Citation Trend
Keywords:
Collateral circulation
Circle of Willis
Interventional radiology
Plethysmograph
Neuroradiology
External carotid artery
Objective To determine the methods and results of treating traumatic pseudoaneurysms in siphon segment of internal carotid artery(ICA)by interventional therapy.Methods Twelve cases of traumatic pseudoaneurysms in siphon segment of internal carotid artery were treated.The collateral circulation of Willis circle was observed after DSA.Different methods of treatment were applied according to the collateral circulation of Willis circle.Ten cases were treated by occlusion of ICA completely,1 case was embolized by guglielmi detachable coil(GDC)only.Results Nine of 12 treated by occlusion of ICA were cured.In the 3 cases who had poor collateral of Willis circle,one was cured by GDC embolization alone;one died 48 hours later after ICA occlusion though his consciousness and the activity of extremities were normal during the temporary balloon test occlusion(BTO)of ICA.One died during the training to improve the collateral of the Willis circle.Conclusion ICA embolization is feasible for treatment of traumatic pseudoaneurysms in siphon segment of internal carotid artery after evaluating the collateral circulation of Willis circle.
Circle of Willis
Collateral circulation
External carotid artery
Anterior cerebral artery
Cite
Citations (0)
Objective:To investigate whether the external carotid artery which has been ligated can get repatency through the ligation or the ramus anastomosis of collateral circulation above and below the ligation position.Methods:From September 1988 to April 1995, the external carotid artery had been ligated in 9 patients with severe epistaxis. Among them, 2 patients had recurrence epistaxis in the side of the ligation,of whom 1 recurred on the 5 years after ligation and 1 recurred on the 7 years after ligation.Digital subtraction angiography on the external carotid artery which had been ligated was performed in order to confirm the relation between the ligated external carotid artery and the recurrence epistaxis in the 2 patients.Result: The external carotid artery which had been ligated could not get repatency through the ligation or the ramus anastomosis of collateral circulation above and below the ligation position,and the ramus anastomosis of collateral circulation above and below the ligation couldn′t had formed. The external carotid artery which had been ligated had no relation with the recurrence of epistaxis.Conclusion: The external carotid artery which have been ligated can not get repatency as time goes on.
External carotid artery
Collateral circulation
Digital subtraction angiography
Cite
Citations (0)
Objective:To study the relationship between compensation by collateral circulation and the quantity of ischemic stroke location.Methods:35 cases of ischemic stroke were retrospectively analyzed.MRI and DSA were performed in all cases,at least one cerebral artery occlusion was found in each patient by DSA,compared the relationship between quantity of Willis circle opening and quantity of ischemic stroke location by SPSS 11.5 statistical software.Results:Of the 35 cases,45 arterial occlusions were found.DSA findings demonstrated internal carotid artery occlusion in 23 cases,vertebral artery-basilar artery occlusion in 22 cases.13 cases of single ischemic stroke location and 4 cases of multiple ischemic stroke locations were found in 17 cases Willis circle opening;11 cases of single ischemic stroke location and 17 cases of multiple ischemic stroke locations were found in 28 cases Willis circle unopening.Conclusion:Intact Willis circle is favorable for collateral circulation establishment when cerebral artery occlusion takes place,Willis circle opening can significantly decrease ischemic stroke location quantity when cerebral artery occlusion is found in this study.
Circle of Willis
Collateral circulation
Stroke
Anterior cerebral artery
Cite
Citations (0)
Collateral circulation
Circle of Willis
External carotid artery
Cite
Citations (34)
Skull base tumors, in addition to blood supply from the external carotid artery, frequently receive a portion of their blood supply from the cavernous portion of the internal carotid artery, especially when the cavernous sinus is invaded by tumor. Preoperative embolization routinely includes obliteration of the supply to the tumor from the external carotid system. However, a variety of strategies are available that enable preoperative embolization of supply from the internal carotid artery as well. These include direct catheterization of cavernous branches of the internal carotid artery, temporary occlusion of the internal carotid artery during external carotid embolization, embolization of the internal carotid artery supply during temporary or permanent occlusion of the internal carotid artery, and internal carotid artery sacrifice. The angiographic anatomy in any particular case dictates these options.
External carotid artery
Sinus (botany)
Blood supply
Cite
Citations (4)
<i>Background and Purpose:</i> In patients with carotid artery occlusion (CAO), collateral flow may reduce the risk of ischemic stroke. Collateral flow via the ophthalmic artery (OphthA) and flow via leptomeningeal vessels have been considered secondary collaterals, which are recruited only if the primary collateral circulation via the circle of Willis is insufficient. The aim of this study was to investigate whether patients with symptomatic CAO who have secondary in addition to primary collaterals have a worse flow state of the brain than those without secondary collaterals, as measured by vascular reactivity testing. <i>Methods:</i> We studied 70 patients with symptomatic CAO who were independent for their daily activities. In all patients, collateral circulation through the circle of Willis was present. Vascular reactivity, measured by means of transcranial Doppler sonography with carbogen inhalation, was compared between patients with and without secondary collaterals. <i>Results:</i> CO<sub>2</sub> reactivity was lower in 64 patients with (mean ± standard deviation 8 ± 14%) than in 6 patients without secondary collaterals (33 ± 18%) resulting in a mean difference of 24% (95% confidence interval 12–37%; p < 0.01). <i>Conclusions:</i> Patients with symptomatic CAO with collateral circulation through the OphthA or through leptomeningeal vessels in addition to collaterals via the circle of Willis have a worse hemodynamic status of the brain than those with Willisian collaterals only. Therefore the presence of these collaterals may indicate insufficiency of collateral blood flow via the circle of Willis.
Circle of Willis
Collateral circulation
Anterior cerebral artery
Transcranial Doppler
Cite
Citations (85)
Objective To assess the collateral ability of the circle of Willis in patients with watershed infarcts.Methods In 100 patients with unilateral internal carotid artery occlusion,collateral circulation pathway in the circle of Willis was measured with transcranial Doppler.Results In patients with watershed infarcts(n=48),collateral circulation pathway in the circle of Willis was not found in 27%,and collateral flow in the posterior communicating artery was found in 13%.In patients without watershed infarcts(n=52),collateral circulation pathway in the circle of Willis not was found in 4%,and the percentage of collateral flow via the posterior communicating artery greatly increased to 52%(P0.01).The percentage of collateral flow via the anterior communicating artery was in the same range for patients with/without watershed infarcts(63% and 67%,respectively).Conclusions In patients with unilateral internal carotid artery occlusion,no collateral circulation pathway in the circle of Willis and a low percentage of collateral flow via the posterior communicating artery is associated with watershed infarcts.
Circle of Willis
Collateral circulation
Posterior communicating artery
Anterior communicating artery
Anterior cerebral artery
Posterior cerebral artery
Transcranial Doppler
Cite
Citations (0)
Objective:To study the formation of collateral circulation after stenosis or occlusion of the carotid arteries.Methods:The clinical data of 142 patients with carotid stenosis or occlusion confirmed by DSA were studied.The collateral circulation and it's association with brain imaging changes were analyzed retrospectively.Results:Seventy-eight patients(54.9%) formed collateral circulation,in which 44 cases were by Willis arterial circle(56.4%),5 by extracranial arteries(6.4%),and 29 by both the Willis arterial circle and extracranial arteries(37.2%).The formation of the collateral circulation was positively related to the degree of stenosis(P0.05),in which the incurrence in patients with double stenosis was significantly higher than that with single stenosis(76.5% vs 52%).Joint compensation from both the cranial and extracranial arteries were more common in patients with unilateral occlusion(P0.05).Compensation with Willis arterial circle was the main way in patients without cranial artery stenosis.However,joint compensation was the main style in patients with cranial artery stenosis.The formation of collateral circulation correlates with the types of cerebral infarction.Watershed infarction was preferentially observed in patients with collateral circulation.Conculsion: The degree of cerebral artery stenosis determines the formation of cerebral collateral circulation which was closely associated with the types of cerebral infarction.
Collateral circulation
Circle of Willis
Cite
Citations (0)
Circle of Willis
Magnetic resonance angiography
Posterior communicating artery
Anterior cerebral artery
Collateral circulation
Cite
Citations (11)
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.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.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.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.
Circle of Willis
Collateral circulation
Posterior communicating artery
Anterior communicating artery
Anterior cerebral artery
Neuroradiology
Posterior cerebral artery
External carotid artery
Cite
Citations (10)