Purpose: We aim to provide prevalence and pattern of anatomical variants of circle of Willis in over one thousand ischemic stroke patients compared to an age- and sex-matched control group, and to determine their role in the severity and in-hospital prognosis.
Methods: Two groups of neuroradiologists evaluated all vascular images of ischemic stroke patients and controls to identify anatomical variants using a preexisted classification. We collected data concerning patient characteristics, stroke severity on admission and discharge, in-hospital mortality, hemorrhagic transformation, acute treatment performed, and etiology.
Results: We included 1131 patients with acute ischemic stroke and 562 controls. Among stroke patients, 702 (62.1%) had one or more vascular variants, compared to 308 (54.8%) of the control group (p < 0.01), 165/702 (23.5%) had an anterior circulation variant only, 384/702 (54.7%) had a posterior circulation variant only, and 153/702 (21.8%) patients had variants in both anterior and posterior circulation. Patients with variants were older (69.7 ± 13.9 years vs 72.0 ± 12.9 years; p = 0.039). The most prevalent variant was the agenesis/hypoplasia of the ACA (201/1131; 17.8%) followed by the unilateral fetal type of the PCA (137/1131; 12.11%).
Conclusions: We provided the prevalence and the pattern of the brain vascular variants of the circle of Willis in a cohort of patients with ischemic stroke. The prevalence of variants was higher in stroke patients compared to controls. Patients with variants were older but had no differences in sex, neurological admission severity, hemorrhagic transformation, etiology, and in-hospital outcome compared to patients with a typical circle of Willis.
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http://dx.doi.org/10.1007/s00415-021-10454-4 | DOI Listing |
J Interv Card Electrophysiol
December 2024
Department of Cardiovascular Diseases, Mayo Clinic, 200 1st Street SW, Rochester, MN, USA.
Background: The efficacy of catheter ablation as a treatment approach for patients with concurrent atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) has been inadequately investigated.
Objective: This study's objective was to assess the effectiveness of atrial fibrillation ablation (AFA) in patients with heart failure with preserved ejection fraction.
Methods: Utilizing the TriNetX research network, we identified individuals aged 18 and older with atrial fibrillation (AF) and concurrent heart failure with preserved ejection fraction (HFpEF) from January 1, 2010, to June 1, 2021.
Eur J Neurol
January 2025
Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Background: This study aimed to explore the association between admission HbA1c and the risk of 1-year vascular outcomes stratified by age group in patients with acute ischemic stroke (AIS) and diabetes mellitus (DM).
Methods: This study analyzed prospective multicenter data from patients with AIS and DM. Admission HbA1C were categorized as:≤6.
Eur J Neurol
January 2025
Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany.
Background: We aimed to investigate the prognostic role of β-synuclein in comparison to that of neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) for predicting functional outcome after acute ischemic stroke (AIS).
Methods: We measured serum concentrations of β-synuclein, NfL and GFAP 24 h after hospital admission in 213 consecutive patients with moderate-to-severe AIS. We investigated the association between serum biomarkers and radiological/clinical characteristics, 3-months mortality and functional outcome on the modified Rankin Scale (mRS).
J Neuroendovasc Ther
October 2024
Department of Neurology, Shanghai Pudong New Area Gongli Hospital, Shanghai, China.
Objective: Giant aneurysms of the cavernous segment of the internal carotid artery presenting as acute ischemic stroke (AIS) are rare and often misdiagnosed. Limited treatment experience further complicates management.
Case Presentation: A 70-year-old female presented with acute right middle cerebral artery (MCA) occlusion due to a dislodged thrombus from a giant internal carotid aneurysm.
Front Cardiovasc Med
December 2024
Cardiovascular Biochemistry Group, Institut de Recerca Hospital de Sant Pau (IR Sant Pau), Barcelona, Spain.
The fundamental role of qualitative alterations of lipoproteins in the early development of atherosclerosis has been widely demonstrated. Modified low-density lipoproteins (LDL), such as oxidized LDL (oxLDL), small dense LDL (sdLDL), and electronegative LDL [LDL(-)], are capable of triggering the atherogenic process, favoring the subendothelial accumulation of cholesterol and promoting inflammatory, proliferative, and apoptotic processes characteristic of atherosclerotic lesions. In contrast, high-density lipoprotein (HDL) prevents and/or reverses these atherogenic effects.
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