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Protocol for Isolating the Mouse Circle of Willis
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Association between circle of Willis and ischemic stroke: a systematic review and meta-analysis
Mohammed Oumer1,2, Mekuriaw Alemayehu3, Abebe Muche4
1Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia. Mohammed.Oumer@uog.edu.et.
Insights
Variations in the Circle of Willis (COW) may increase ischemic stroke risk, but this meta-analysis found no significant association. Further research is needed to clarify the link between COW anatomy and stroke development.
Area of Science:
- Neurology
- Vascular Biology
- Public Health
Background:
- The Circle of Willis (COW) is crucial for maintaining regular blood flow to the brain and preventing ischemia.
- Stroke remains a leading global cause of death and adult disability, with increasing concerns about ischemic stroke.
- A clear understanding of the association between COW variations and ischemic stroke is essential.
Purpose of the Study:
- To provide comprehensive and up-to-date evidence on the association between Circle of Willis variations and ischemic stroke.
- To conduct a systematic review and meta-analysis of available studies.
Main Methods:
- Systematic search of PubMed, Google Scholar, Science Direct, and Cochrane Library databases.
- Data extraction using a standardized template and assessment of study heterogeneity.
- Application of a fixed-effect model to estimate the pooled measure of association.
Main Results:
- The meta-analysis included 2,718 participants.
- A pooled odds ratio of 1.38 (95% CI 0.87, 2.19) suggested a potential increased likelihood of ischemic stroke with COW variations.
- Hypoplasia of the posterior communicating artery (PcomA) and anterior communicating artery (AcomA) were identified as potential contributing factors.
Conclusions:
- This meta-analysis found a non-significant positive association between Circle of Willis variations and ischemic stroke.
- While specific variations like PcomA and AcomA hypoplasia showed a trend towards increased risk, the overall association was not statistically significant.
Background:
Circle of Willis is the main structure that provides constant and regular blood flow to the brain, protects the brain from ischemia. Stroke has remained the second leading cause of death globally in the last fifteen years. It is the fifth leading cause of death in the United States. It is also the leading cause of serious adult disability. Interlinked problems related to ischemic stroke are become increasing nowadays. Strong evidence is needed about the pooled measure of association between the circle of Willis (COW) and ischemic stroke. Therefore, this systematic review and meta-analysis were intended to provide compressive and up to date evidence on the association between the variations of COW and ischemic stroke using the available studies.
Methods:
PubMed, Google Scholar, Science Direct, and Cochrane Library databases were systematically searched. All essential data were extracted using a standardized data extraction template. The heterogeneity across studies was assessed by using the Cochrane Q test statistic, I2 test statistic, and P-values. A fixed-effect model was used to estimate the pooled effect of the measure association between COW and ischemic stroke.
Results:
In this meta-analysis, 2,718 participants were involved. The pooled measure of association between COW and ischemic stroke was 1.38 (95% CI 0.87, 2.19). Therefore, this indicated that the presence of any variation in COW was 1.38 times more likely to develop ischemic stroke as compared to the patent COW. The presence of hypoplasia/incompleteness in a posterior communicating artery (PcomA) [Pooled OR: 1.34 (95% CI 0.80, 2.25)] and anterior communicating artery (AcomA) [Pooled OR: 1.32 (95% CI 0.81, 2.19)] were a contributing factor for the development of ischemic stroke. Hypertension was the most common comorbid condition, followed by diabetes mellitus, smoking, coronary artery disease, and hyperlipidemia.
Conclusions:
There was a non-significant positive association between COW variation and ischemic stroke in this meta-analysis.
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