The Anatomy of the Circle of Willis Is Not a Strong Enough Predictive Factor for the Prognosis of Cross-Clamping Intolerance During Carotid Endarterectomy

Overview

Journal J Clin Med

Specialty General Medicine

Date 2020 Dec 5

PMID 33276586

Citations 3

Authors

Piotr Myrcha

Andrzej Lewczuk

Maciej Jakucinski

Mariusz Kozak

Dawid Siemieniuk

Dorota Rozanski

Dariusz Koziorowski

Witold Wozniak

Affiliations

Soon will be listed here.

Abstract

Material And Methods: 40 patients after CEA with CC intolerance were included in Group I, and 15 with CC tolerance in Group II. All patients underwent MRA of the circle of Willis (CoW), P-MR with or without Acetazolamide; P(A)-MR in the postoperative period.

Results: CoW was normal in the MRA in three cases (7.5%) in Group I, and in eight (53%) in Group II. We found P-MR abnormalities in all patients from Group I and in 40% from Group II. Using a calculated cut-off point of 0.322, the patients were classified as CC tolerant with 100% sensitivity or as CC intolerant with 95% specificity. After evaluating P-MR or MRA alone, the percentage of false negative results significantly increased.

Conclusion: The highest value in predicting cross-clamping intolerance is achieved by using analysis of P(A)-MR and MRA of the CoW in combination.

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