ArticleEuropean journal of neurology2021
Circle of Willis variants and their association with outcome in patients with middle cerebral artery-M1-occlusion stroke.
Article in European journal of neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Circle of Willis Configuration and Thrombus Localization Impact on Ischemic Stroke Patient Outcomes: A Systematic Review.Medicina (Kaunas, Lithuania) · 2023Pooled it
- ACA-A1 segment development affects basal ganglia infarct severity and thrombectomy safety in MCA occlusion.European stroke journal · 2026Article
- Genetic determinants of insufficiency of the collateral circulation.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026Review
- Assessing Arterial Patterns in the Motor Cortex With 7 Tesla Magnetic Resonance Imaging and Vessel Distance Mapping.Human brain mapping · 2025Article
- Integrated Strategies for Targeting Arteriogenesis and Angiogenesis After Stroke.Translational stroke research · 2025Review
- Article
- Anomalous vertebral arteries and recurrent ischemic stroke: Insights from a unique case (first documented case-report from Syria).Medicine · 2025Article
- Circle of Willis Variants and Their Association with Outcome after Successful Revascularization of Anterior Large Vessel Occlusion.AJNR. American journal of neuroradiology · 2025Article
- Association of deep tiny flow voids with prognosis of acute middle cerebral artery atherosclerotic occlusion.Frontiers in human neuroscience · 2025Article
- Collateral is brain: Low perfusion triggers spreading depolarization and futile reperfusion after acute ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024Article
- Introducing the Futile Recanalization Prediction Score (FRPS): A Novel Approach to Predict and Mitigate Ineffective Recanalization after Endovascular Treatment of Acute Ischemic Stroke.Neurology international · 2024Article
- Modeling cerebrovascular responses to assess the impact of the collateral circulation following middle cerebral artery occlusion.Microcirculation (New York, N.Y. : 1994) · 2024Article
- Recruitment of pial collaterals and carotid occlusive disease in large-vessel occlusion ischemic stroke.Frontiers in neurology · 2024Article
- Prognostic analysis of endovascular mechanical thrombectomy in stroke patients with acute internal carotid artery obstruction based on circle of Willis variation.Frontiers in neurology · 2024Article
- The Presence of Communicating Arteries in the Circle of Willis Is Associated with Higher Rate of Functional Recovery after Anterior Circulation Ischemic Stroke.Biomedicines · 2023Article
- High posterior cerebral artery flow predicts ischemia recurrence in patients with internal carotid artery occlusion.Frontiers in neurology · 2023Article
- Quantitative Collateral Assessment on CTP in the Prediction of Stroke Etiology.AJNR. American journal of neuroradiology · 2022Article
- Risk Factors of Impaired Perfusion in Patients With Symptomatic Internal Carotid Artery Steno-Occlusive Disease.Frontiers in neurology · 2022Article
- Circle of Willis variants and their association with outcome in patients with middle cerebral artery-M1-occlusion stroke.European journal of neurology · 2021Article
Corrections and comments
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Authors and funding
18 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn incomplete circle of Willis (CoW) has been associated with a higher risk of stroke and might affect collateral flow in large vessel occlusion (LVO) stroke. We aimed to investigate the distribution of CoW variants in a LVO stroke and transient ischemic attack (TIA) cohort and analyze their impact on 3-month functional outcome.
methodsCoW anatomy was assessed with time-of-flight magnetic resonance angiography (TOF-MRA) in 193 stroke patients with acute middle cerebral artery (MCA)-M1-occlusion receiving endovascular treatment (EVT) and 73 TIA patients without LVO. The main CoW variants were categorized into four vascular models of presumed collateral flow via the CoW.
results82.4% (n = 159) of stroke and 72.6% (n = 53) of TIA patients had an incomplete CoW. Most variants affected the posterior circulation (stroke: 77.2%, n = 149; TIA: 58.9%, n = 43; p = 0.004). Initial stroke severity defined by the National Institutes of Health Stroke Scale (NIHSS) on admission was similar for patients with and without CoW variants. CoW integrity did not differ between groups with favorable (modified Rankin Scale [mRS]): 0-2) and unfavorable (mRS: 3-6) 3-month outcome. However, we found trends towards a higher mortality in patients with any type of CoW variant (p = 0.08) and a higher frequency of incomplete CoW among patients dying within 3 months after stroke onset (p = 0.119). In a logistic regression analysis adjusted for the potential confounders age, sex and atrial fibrillation, neither the vascular models nor anterior or posterior variants were independently associated with outcome.
conclusionOur data provide no evidence for an association of CoW variants with clinical outcome in LVO stroke patients receiving EVT.
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