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Study on the correlation between the circle of Willis structure and collateral circulation in bilateral carotid

Yang Liu1, Lei Zhu2, Bei Hou3

  • 1Department of Neurology, The Second Affiliated Hospital of Qiqihar Medical university, No.37 West Zhonghua Road, Qiqihar, 161006, Heilongjiang, China.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|April 24, 2021
PubMed

Insights

The structure of the circle of Willis (CoW) significantly impacts collateral circulation in bilateral carotid artery occlusion (CAO). Incomplete CoW relies on secondary pathways, while partially complete CoW uses primary collateral circulation for blood flow compensation.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Medical Imaging

Background:

  • Bilateral carotid artery occlusion (CAO) presents complex collateral circulation challenges.
  • The circle of Willis (CoW) is a critical but not fully understood collateral pathway in CAO.

Purpose of the Study:

  • To investigate the specific role of the circle of Willis (CoW) in collateral circulation compensation for bilateral carotid artery occlusion (CAO).

Main Methods:

  • Analysis of clinical, imaging, and hemodynamic data from 30 patients with bilateral CAO.
  • Examination of the correlation between CoW structure and collateral circulation pathways in bilateral CAO.

Main Results:

  • No complete CoW observed in 30 bilateral CAO patients; 60% had partially complete and 40% incomplete CoW.
  • Partially complete CoW predominantly utilized anterior communicating artery (ACoA) and posterior cerebral artery-middle cerebral artery (PCA-MCA) leptomeningeal anastomosis (LMA) for anterior circulation.
  • Incomplete CoW cases showed a higher reliance on PCA-MCA LMA and ophthalmic artery (OA) for collateral compensation.

Conclusions:

  • CoW structure dictates the collateral circulation pathway in bilateral CAO.
  • Partially complete CoW primarily uses direct collateral pathways, while incomplete CoW relies on secondary collateral pathways for blood flow compensation to ischemic areas.
Abstract

Keywords:
Blood stealingCarotid stenosis/occlusionCircle of WillisCollateral circulation

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