Atheromatosis of the brain-supplying arteries: Circle of Willis, basilar, vertebral and their branches

Llopis, G; Quinones, Sara; Konschake, Marko; Blas, Clara Simón de; Hernández, L. M.; Abramović, Anto; Viñuela-Prieto, JM; Sañudo, José Ramón; Tubbs, R. Shane; Maranillo, Eva

doi:10.1016/j.aanat.2022.151941

Cited by 3 publications

(3 citation statements)

References 33 publications

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“…[26]. In a study by Llopis et al, which examined a total of 261 atherosclerotic plaques, only two were identified in the ACoA [27].…”

Section: Atherosclerosis Of the Circle Of Willismentioning

confidence: 99%

“…The atherosclerotic patterns involving the circle of Willis have been explored in previous studies [23][24][25][26][27]. It is established that the larger intracranial arteries, such as the internal carotid, middle cerebral, basilar, and vertebral arteries, frequently exhibit more extensive atherosclerotic damage compared to the smaller segments of the circle of Willis [20,[23][24][25][26].…”

Section: Atherosclerosis Of the Circle Of Willismentioning

confidence: 99%

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Examining Atherosclerosis Patterns in the Circle of Willis: A Case Study of Duplicated Anterior Communicating Artery

Tritsch,

Shoja,

Schleffer

et al. 2024

Cureus

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The anterior communicating artery (ACoA) plays a pivotal role in maintaining cerebral hemodynamics, as its diameter is a major determinant of blood collateralization through the circle of Willis following internal carotid artery occlusion. While variations of this artery are not uncommon, data on their clinicopathologic relevance are limited. In this report, we present our observation from a fresh cadaver of a male individual who had succumbed to cardiac causes. The circle of Willis displayed a duplicated ACoA with atherosclerosis that predominantly affected the posterior horn while sparing the anterior horn. The anterior horn was characterized by its shorter length and larger diameter compared to the posterior horn. The paper focuses on elucidating the microsurgical anatomy of this particular ACoA variant and exploring potential mechanisms that may underlie the pattern of atherosclerotic distribution within the circle of Willis. Based on this report, while further evidence is needed for confirmation, it is plausible that the existence of a duplicated ACoA may offer a protective mechanism, ensuring uninterrupted collateral circulation in the event of a blockage in one of the horns. Further analysis of the ACoA and its pattern of involvement in intracranial atherosclerosis is warranted, as the atherosclerotic patterns in this region hold clinical and pathological significance.

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“…[26]. In a study by Llopis et al, which examined a total of 261 atherosclerotic plaques, only two were identified in the ACoA [27].…”

Section: Atherosclerosis Of the Circle Of Willismentioning

confidence: 99%

Section: Atherosclerosis Of the Circle Of Willismentioning

confidence: 99%

Examining Atherosclerosis Patterns in the Circle of Willis: A Case Study of Duplicated Anterior Communicating Artery

Tritsch,

Shoja,

Schleffer

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

“…Der systematische Einsatz kathetergestützter invasiver Verfahren zur mechanischen Entfernung von Thromben aus den "großen" zerebralen Gefäßen (der Durchmesser der größten zerebralen Arterie beträgt ca. 4 mm [Llopis et al 2022]) begann 2004 im Rahmen einer kontrol-lierten Studie (Smith et al 2008), wurde aber erst nach fünf im Jahre 2015 publizierten für die Schlaganfallbehandlung revolutionären "Landmark-Studien", als Standard-Therapieverfahren in nationalen und internationalen Leitlinien etabliert (s. Abb. 1 u.…”

Section: Warum Mechanische Thrombektomie (Mte)unclassified

Aus der Sicht eines erfahrenen Peers, was haben die Peer Reviews an Ihrer Klinik verändert?

Gahn¹

2023

Handbuch IQM. Konsequent Transparent – Qualität Mit Routinedaten! 3. Auflage

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Sie ist immer noch die Grundlage der von Neurologen vorangetriebenen Erfolgsgeschichte der Stroke Units in Deutschland. Die Zertifizierung der Stroke Units durch die Deutsche Schlaganfallgesellschaft stellt einen wesentlichen Aspekt der Qualitätskontrolle bei der Schlaganfallbehandlung dar. Das Stroke-Unit-Zertifikat wird seit 2004 vergeben und beruht überwiegend auf Strukturqualität und kann mittelbar auch abrechnungsrelevant gegenüber den Kostenträgern sein. Die externe Qualitätssicherung stellt eine weitere Grundlage der Schlaganfallversorgung dar. Die Teilnahme an diesem Verfahren ist in verschiedenen Bundesländern für die an der Schlaganfallbehandlung beteiligten Krankenhäuser gesetzlich verpflichtend (Geraedts et al. 2021). Die Krankenhäuser müssen hierbei Daten zu Versorgungsprozessen und -ergebnissen zur Verfügung stellen, die im Vergleich mit anderen rückgemeldet und auch sanktioniert werden. Ziel ist die Entwicklung von Verbesserungsprozessen. Allerdings fehlen bisher Verfahren zur Prüfung der zugrundeliegenden Datenqualität bzw. Reliabilität.

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Endovascular recanalization of symptomatic non-acute occlusion of the vertebrobasilar artery

Zhou

Zhu

et al. 2023

Front. Neurol.

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PurposeThe study aimed to investigate the safety, effect, and risk factors of endovascular recanalization of symptomatic non-acute occlusion of the vertebrobasilar artery (SNOVA).Materials and methodsPatients with SNOVA were retrospectively enrolled and treated with endovascular recanalization. The clinical data, endovascular treatment, peri-procedural complications, and follow-up outcomes were analyzed.ResultsA total of 88 patients were enrolled, with an interval to recanalization of 2–89 days (median 23) and an mRS of 2–5 (median 3 and IQR 1). Occlusion was in the intracranial vertebral artery in 68 (77.27%) patients and basilar artery in 20 (22.73%), with an occlusion length of 4.5–43.7 mm (mean 18.3 ± 8.8). Endovascular recanalization was successful in 81 (92.0%) patients. Post-dilatation was performed in 23 (28.4%) patients. After stenting, the residual stenosis was 10%–40% (mean 20.2% ± 7.6%). Peri-procedural complications occurred in 17 (19.3%) patients, with a mortality rate of 5.7%. In total, 79 (95.18%) patients underwent follow-up 5–29 (mean 16.9 ± 5.5) months later, with an mRS score of 0–6 (median 1 and IQR 1) at follow-up, being significantly (p < 0.0001) better than that at discharge. Stroke occurred in 9 patients (11.4%) in 1 year. In-stent restenosis occurred in 19 (25.33%) patients. Significant (p < 0.05) independent risk factors were blunt occlusion for successful recanalization, duration to recanalization and blunt occlusion for peri-procedural complications, and post-dilatation for both in-stent restenosis and 1-year stroke or death events.ConclusionEndovascular recanalization of symptomatic non-acute occlusion of the vertebrobasilar artery is feasible even for a long occlusion segment, with a high recanalization rate, a low complication rate, and a good prognosis. Blunt occlusion and duration from the onset to recanalization may affect successful recanalization and peri-procedural complications while post-dilatation may affect in-stent restenosis and prognosis.

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Atheromatosis of the brain-supplying arteries: Circle of Willis, basilar, vertebral and their branches

Cited by 3 publications

References 33 publications

Examining Atherosclerosis Patterns in the Circle of Willis: A Case Study of Duplicated Anterior Communicating Artery

Examining Atherosclerosis Patterns in the Circle of Willis: A Case Study of Duplicated Anterior Communicating Artery

Aus der Sicht eines erfahrenen Peers, was haben die Peer Reviews an Ihrer Klinik verändert?

Endovascular recanalization of symptomatic non-acute occlusion of the vertebrobasilar artery

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