Impact of anatomical variations of the circle of Willis on the incidence of aneurysms and their recurrence rate following endovascular treatment

Songsaeng, Dittapong; Geibprasert, Sasikhan; Willinsky, Robert A.; Tymianski, Michael; terBrugge, Karel G.; Krings, Timo

doi:10.1016/j.crad.2010.06.010

Cited by 51 publications

(46 citation statements)

References 31 publications

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“…The relatively higher frequency of caudal BA fusion in patients with BTA is in accordance with previously published data18 19 and our findings reinforce the importance of BA fusion type in the formation of BTA.…”

Section: Discussionsupporting

confidence: 93%

“…Campos et al ,18 identified P1 agenesis in 2.8% of 47 patients with BTA, but hypoplastic P1 segments were not assessed and no data on the prevalence of those variants in individuals without BTA were given. In another study investigating the effect of anatomical variations on the incidence of aneurysm recurrence after treatment, Songsaeng et al ,19 found a positive association between fPCA and recurrence of posterior communicating artery aneurysms. To our knowledge, this is the first study to examine the specific association of persistent fPCA and aneurysms of the basilar apex.…”

Section: Discussionmentioning

confidence: 97%

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Low prevalence of fetal-type posterior cerebral artery in patients with basilar tip aneurysms

Diogo

Fragata

Dias

et al. 2016

J NeuroIntervent Surg

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Background Basilar tip aneurysms (BTA) are multifactorial in origin, with luminal forces playing a major role in their formation. Considering the reduced hemodynamic stress on the basilar apex in the fetal-type posterior cerebral artery (fPCA), we hypothesize that BTA should be less common in patients with this variant. Objective To investigate, in a retrospective casecontrol study, the frequency of fPCA in patients with and without BTA. Materials and methods We collected clinical and imaging data from consecutive patients with BTA undergoing catheter angiography between July 2010 and July 2015, and from a randomly selected, age-and sex-matched non-BTA control population from our prospective database. Anatomical variants of the distal basilar artery region were assessed in the two groups and compared using parametric and non-parametric tests. Results Fifty-nine BTA cases and 337 controls were included. fPCA was present in 3% of patients with BTA and 23% in the control group ( p<0.001; OR=0.11, 95% CI 0.03 to 0.48). Basilar tip disposition was cranial in 49% of BTA and 63% of non-BTA cases ( p=0.04; OR=0.57, 95% CI 0.33 to 0.99); a caudal disposition was found in 24% and 6% of cases, respectively ( p<0.001; OR=4.65, 95% CI 2.21 to 9.80). Conclusions We found a statistically significant association between the absence of fPCA and BTA. Our findings underline the importance of hemodynamic stress in the formation of intracranial aneurysms, and suggest that fPCA is a protective variant for formation of BTA.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 97%

Low prevalence of fetal-type posterior cerebral artery in patients with basilar tip aneurysms

Diogo

Fragata

Dias

et al. 2016

J NeuroIntervent Surg

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“…A recent study 125 found that basilar tip aneurysms occur more often with asymmetric artery fusion, which could be related to a more fragile vessel disposition as it is not fully matured or to a possible local increase in the hemodynamic stress in these locations. Aneurysms of the PICA are relatively rare, they account for approximately 2–3% of all intracranial aneurysms and about 18% of all aneurysms in the posterior circulation, but aneurysms in this location have a high rupture rate (approximately 80% are ruptured) 99 .…”

Section: Locationmentioning

confidence: 99%

Suggested Connections Between Risk Factors of Intracranial Aneurysms: A Review

Cebral

Raschi

2012

Ann Biomed Eng

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The purpose of this article is to review studies of aneurysm risk factors and the suggested hypotheses that connect the different risk factors and the underlying mechanisms governing the aneurysm natural history. The result of this work suggests that at the center of aneurysm evolution there is a cycle of wall degeneration and weakening in response to changing hemodynamic loading and biomechanic stress. This progressive wall degradation drives the geometrical evolution of the aneurysm until it stabilizes or ruptures. Risk factors such as location, genetics, smoking, co-morbidities, and hypertension seem to affect different components of this cycle. However, details of these interactions or their relative importance are still not clearly understood.

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“…10,11,15,16 A limited number of case series have detailed the clinical outcomes, angiographic results, and procedure-related complications specific for endovascular treatment in this location. [10][11][12][13][15][16][17][18][19][20][21][22][23][24] We performed a systematic review of the published literature to better define safety and efficacy profiles for coil embolization of AcomA aneurysms beyond single-center experiences.…”

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confidence: 99%

Endovascular Treatment of Anterior Communicating Artery Aneurysms: A Systematic Review and Meta-Analysis

Fang

Brinjikji

Murad

et al. 2013

American Journal of Neuroradiology

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Impact of anatomical variations of the circle of Willis on the incidence of aneurysms and their recurrence rate following endovascular treatment

Cited by 51 publications

References 31 publications

Low prevalence of fetal-type posterior cerebral artery in patients with basilar tip aneurysms

Low prevalence of fetal-type posterior cerebral artery in patients with basilar tip aneurysms

Suggested Connections Between Risk Factors of Intracranial Aneurysms: A Review

Endovascular Treatment of Anterior Communicating Artery Aneurysms: A Systematic Review and Meta-Analysis

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