Abstract
A prospective survey of 330 arch aortograms performed to investigate patients with suspected cerebrovascular insufficiency is analysed to assess the functional importance of extracranial vascular disease. A detailed statistical analysis of the extracranial arterial obstructive lesions is presented. Extracranial atheromatous stenosis or occlusions are often associated with clinical cerebrovascular insufficiency and the lesions are often multiple. Nevertheless extensive arterial disease may be present with minor (or no) symptoms. The critical factors in determining whether or not symptoms occur are the haemodynamic state and the adequacy of the collateral pathways. The functional integrity of the Circle of Willis is of major importance in this respect.
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