Incompleteness of circle of Willis and silent brain infarction in patients with internal carotid artery stenosis

Abstract

PurposeTo investigate the association between the prevalence of silent brain infarction (SBI) and incompleteness of circle of Willis (CoW) in patients with internal carotid artery stenosis (ICA). MethodsWe included patients with unilateral intra- or extracranial ICA stenosis ≥ 50% or occlusion without previous history of stroke or transient ischemic attack. SBIs were evaluated on magnetic resonance image. We compared SBI prevalence between patients with complete and incomplete CoW, and between ipsilateral and contralateral hemispheres to stenosed ICA. ResultsWe included 257 patients with ICA stenosis, among them 120 patients had complete CoW and 137 patients had incomplete CoW. SBI prevalence was significantly higher in patients with incomplete CoW than those with complete CoW (73.0% vs 43.3%, OR 3.09, 95% CI 1.70–5.63). Further, in patients with incomplete CoW, SBIs prevalence was significantly higher in ipsilateral hemisphere than that in contralateral hemisphere (63.5% vs 46.7%, OR = 2.01, 95% CI 1.21–3.34). While, in patients with complete CoW, SBI prevalence was not significantly different between two hemispheres (31.7% vs 23.3%, OR = 1.51, 95% CI 0.83–2.73). ConclusionIn patients with ICA stenosis, SBI prevalence was associated with incompleteness of CoW.