Article: Incomplete circle of Willis as a risk factor for intraoperative ischemic events during carotid endarterectomies performed under regional anesthesia - A prospective case-series.
2023 Volume 14, Issue 1, Page(s) 20220293
Abstract: Background: The role of the willisian collaterals during carotid endarterectomies (CEAs) is a debated issue. The aim of the present work was to test whether an incomplete or non-functional circle of Willis (CoW) is a risk factor for ischemic events ... ...
| Abstract | Background: The role of the willisian collaterals during carotid endarterectomies (CEAs) is a debated issue. The aim of the present work was to test whether an incomplete or non-functional circle of Willis (CoW) is a risk factor for ischemic events during CEA. Patients and methods: CEAs were performed under local anesthesia. Patients were considered symptomatic (SY) if neurological signs appeared after the cross-clamping phase. In SY patients shunt insertion was performed. CoW on CT angiograms (CTa) were analyzed offline and categorized as non-functional (missing or hypoplastic collaterals) or functional collaterals by three neuroradiologists. Near-infrared spectroscopy (NIRS) was performed throughout the procedure. Results: Based on CTa, 67 incomplete circles were found, 54 were asymptomatic (ASY) and 13 were SY. No complete CoW was found among the SY patients. Significant differences could be detected between incomplete and complete circles between ASY and SY groups (Chi-square: 6.08; Conclusions: Collateral ability of the CoW may be a risk factor for ischemic events during CEAs. Further studies should delineate whether the preoperative assessment of collateral capacity may be useful in decision-making about shunt use during CEA. |
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| Language | English |
| Publishing date | 2023-07-10 |
| Publishing country | Germany |
| Document type | Journal Article |
| ZDB-ID | 2581219-1 |
| ISSN | 2081-6936 ; 2081-3856 |
| ISSN (online) | 2081-6936 |
| ISSN | 2081-3856 |
| DOI | 10.1515/tnsci-2022-0293 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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