CCL

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001-es BibID:BIBFORM057003
Első szerző:Hoksbergen, Arjan W. J.
Cím:Absent Collateral Function of the Circle of Willis as Risk Factor for Ischemic Stroke / A. W. J. Hoksbergen, D. A. Legemate, L. Csiba, G. Csati, P. Siro, B. Fulesdi
Dátum:2003
ISSN:1015-9770
Megjegyzések:Background: Autopsy studies show a higher prevalence of circle of Willis anomalies in brains with signs of ischemic infarction. Our goal was to examine the collateral function of the circle of Willis in ischemic stroke patients and to assess in a case-control study if a collateral deficient circle of Willis is a risk factor for ischemic stroke in patients with severe internal carotid artery (ICA) occlusive disease. Methods: Our case-control study included 109 patients with an acute ischemic stroke in the anterior circulation and 113 patients with peripheral arterial disease and no known history of cerebral ischemia. The collateral function of the anterior and posterior communicating arteries of the circle of Willis was assessed by means of transcranial color-coded duplex ultrasonography (TCCD) and carotid compression tests. Results: TCCD was successfully performed in 75 case patients (mean age 64 years, range 41-91 years) and in 100 control patients (mean age 61 years, range 35-89 years). In 26 cases and 19 controls, a ? 70% stenosis or occlusion of the ICA was found. A nonfunctional anterior collateral pathway in the circle of Willis was found in 33% of the cases and in 6% of the controls (p < 0.001). The posterior collateral pathway was nonfunctional in 57% of the cases and in 43% of the controls (p = 0.02). In patients with severe ICA occlusive disease, the odds ratios of a nonfunctional anterior and a nonfunctional posterior collateral pathway were 7.33 (95% confidence interval, CI, = 1.19-76.52) and 3.00 (95% CI = 0.77-12.04), respectively. Conclusions: Patients who suffer ischemic stroke in the anterior circulation have a higher incidence of collateral deficient circles of Willis than those with atherosclerotic vascular disease without ischemic cerebrovascular disease. The presence of a nonfunctional anterior collateral pathway in the circle of Willis in patients with severe ICA occlusive disease is strongly associated with ischemic stroke.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Cerebral ischemia
Circle of Willis
Collateral circulation
Transcranial ultrasound
Megjelenés:Cerebrovascular Diseases. - 16 : 3 (2003), p. 191-198. -
További szerzők:Legemate, D. Csiba László (1952-) (neurológus, pszichiáter) Csáti Géza Siró Péter (1973-) (neurológus, aneszteziológus, intenzív terápiás szakorvos) Fülesdi Béla (1961-) (aneszteziológus)
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2.

001-es BibID:BIBFORM105018
035-os BibID:(WOS)000879996500001 (Scopus)85142129652
Első szerző:Orosz László (sebész)
Cím:Assessment of malformations, variations and diameters of vessels forming the circle of Willis : An autopsy study in a non-cerebrovascular cohort / Orosz László, Gyöngyösi Zoltán, Susán Zsolt, Siró Péter, Hoksbergen Arjan Willem, Csiba László, Fülesdi Béla
Dátum:2022
ISSN:2081-3856 2081-6936
Megjegyzések:Background a purpose The collateral capacity of the circle of Willis (CoW) may play an important role in the development of ischemic strokes. The occurrence of classical polygon shows wide geographical variations and morphological data on diameters of the Willisian collaterals are scarce. We aimed to assess CoW variations and vessel diameters in a Central European cohort. Subjects and methods CoWs were removed during routine autopsy. The morphological pattern of the circles was recorded. The prepared circles were then put between two glass plates and tightly compressed. The length of the vessels and half of the circumference were measured under a light microscope enabling measurement with an approximation of 0.1?mm. Vessel diameters were calculated from vessel circumference. Results A total of 110 circles were analysed. Incomplete circles (missing one or two segments of CoW) were found in 25 cases (22.7%). Any forms of anatomical variations were detected in 14 cases (12.7%). When applying the <1?mm diameter threshold for analysis, 36 anterior communicating arteries (32.7%), 53 right posterior communicating arteries (48.2%), 73 left posterior communicating arteries (66.4%) and 18 posterior communicating arteries (16.3%) on both the sides were considered hypoplastic. Conclusions In patients without stroke in their history, complete CoW may be present in >60% of the cases. Our diameter data may serve as reference values for the Central-European population.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Translational Neuroscience. - 13 : 1 (2022), p. 398-406. -
További szerzők:Gyöngyösi Zoltán (1977-) (aneszteziológus) Susán Zsolt (1983-) (sebész) Siró Péter (1973-) (neurológus, aneszteziológus, intenzív terápiás szakorvos) Hoksbergen, Arjan W. J. Csiba László (1952-) (neurológus, pszichiáter) Fülesdi Béla (1961-) (aneszteziológus)
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3.

001-es BibID:BIBFORM029163
Első szerző:Orosz László (sebész)
Cím:Clinical applicability of a mathematical model in assessing the functional ability of the communicating arteries of the circle of Willis / László Orosz, Arjan W. Hoksbergen, Csilla Molnár, Péter Siró, Francis Cassot, Jean-Pierre Marc-Vergnes, Béla Fülesdi
Dátum:2009
Megjegyzések:The brain collateral blood supply, which is essential in patients suffering from significant stenoses or occlusions of the extracranial arteries, remains difficult to assess accurately in practice. We compared data obtained from transcranial color-coded duplex sonography (TCCD) combined with carotid compression tests to morphometric autopsy data and to results given by a mathematical model of the cerebral macrocirculation. METHODS AND RESULTS: In 16 moribund patients, anterior and posterior communicating arteries of the circle of Willis were divided into functional and non-functional based on the results of the TCCD combined with carotid compression tests. After death of the patients diameters and lengths of the main intracranial arteries were measured at autopsy and these values were treated with a mathematical model for calculating blood flow and blood pressure in all the segments of the arterial network. The diameters and the blood flows through the communicating arteries were found to be significantly higher in the group of functional arteries than in that of non-functional ones. However, blood flow was also shown to be dependent on other parameters such as the pressure difference between the two ends of the vessel. CONCLUSION: Our data indicate that functional ability of the Willisian collaterals depends on morphological and functional parameters, and is therefore better assessed by a functional method, such as TCCD, than by a solely morphological one, such as cerebral angiography. Mathematically based circulation modeling, when it will be possible, could be a more comprehensive tool for delineating patients at a higher risk for hemodynamic cerebrovascular insufficiency.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
egyetemen (Magyarországon) készült közlemény
Megjelenés:Journal of the Neurological Sciences. - 287 : 1-2 (2009), p. 94-99. -
További szerzők:Hoksbergen, Arjan W. J. Molnár Csilla (1962-) (aneszteziológus) Siró Péter (1973-) (neurológus, aneszteziológus, intenzív terápiás szakorvos) Cassot, Francis Marc-Vergnes, Jean-Pierre Fülesdi Béla (1961-) (aneszteziológus)
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