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Brief report
Circle of Willis variants are not associated with thrombectomy outcomes
  1. Thomas Seifert-Held1,
  2. Katharina Eberhard2,
  3. Soren Christensen3,
  4. Edith Hofer1,
  5. Christian Enzinger1,
  6. Gregory W Albers3,
  7. Maarten Lansberg3
  1. 1 Department of Neurology, Medical University of Graz, Graz, Austria
  2. 2 Core Facility Computational Bioanalytics, Center for Medical Research, Medical University of Graz, Graz, Austria
  3. 3 Department of Neurology & Neurological Sciences, Stanford University, Stanford, California, USA
  1. Correspondence to Dr Thomas Seifert-Held; thomas.seifert{at}medunigraz.at

Abstract

Background The circle of Willis (COW) is part of the brain collateral system. The absence of COW segments may affect functional outcome in patients with ischaemic stroke undergoing endovascular therapy.

Methods In 182 patients in the Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution 2 Study and the CT Perfusion to Predict Response to Recanalisation in Ischaemic Stroke Project, COW anatomy was evaluated on postinterventional magnetic resonance angiography. The absence of the posterior communicating artery or the first segments of posterior or anterior cerebral arteries ipsilateral to the ischaemic infarction was rated as an incomplete COW. Logistic regression was applied to evaluate an association with the patients’ modified Rankin scale (mRS) at 90 days after stroke

Results An incomplete ipsilateral COW was not predictive of the patients’ mRS at 90 days after stroke. Significant associations were shown for the patients’ baseline National Institutes of Health Stroke Scale (NIHSS), age and reperfusion status. The effect size suggests that a significant association of an incomplete COW with the mRS at 90 days may be obtained in cohorts of more than 3000 patients.

Conclusions Compared with the established predictors NIHSS, age and reperfusion status, an incomplete COW is not associated with functional outcome after endovascular therapy.

  • stroke
  • thrombectomy
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/svn-2020-000491

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    Footnotes

    • TS-H and KE contributed equally.

    • Contributors TS-H: Design and concept of study; Data collection and analysis, drafting and revision of manuscript. KE: Data collection and analysis, drafting and revision of manuscript. SC: Data collection and analysis, drafting and revision of manuscript. EH: Data collection and analysis, drafting and revision of manuscript. CE: Drafting and revision for intellectual content. GWA: Drafting and revision for intellectual content. ML: Design and concept of study; Data collection and analysis, drafting and revision of manuscript

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests SC performs consulting work for iSchemaView; GWA is a consultant of iSchemaView and has an equity interest in iSchemaView.

    • Provenance and peer review Not commissioned; externally peer reviewed.