The Circle of Willis and White Matter Lesions in Patients with Carotid Atherosclerosis

Background The correlation between cerebral atherosclerosis and white matter lesions (WMLs) in the elderly was controversial in the published articles, where the stenosis was often evaluated by ultrasonography, computed tomography angiography, or magnetic resonance angiography and collaterals were s...

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Published in:Journal of stroke and cerebrovascular diseases 2015-08, Vol.24 (8), p.1749-1754
Main Authors: Li, Hua, MD, Xiong, Yunyun, MD, PhD, Xu, Gelin, MD, Zhang, Renliang, MD, Zhu, Wusheng, MD, Yin, Qin, MB, Ma, Minmin, MD, Fan, Xiaobing, MM, Yang, Fang, MD, Liu, Wenhua, MD, Duan, Zuowei, MM, Liu, Xinfeng, MD
Format: Article
Language:English
Subjects:
Aged
atherosclerosis
Cardiovascular
Carotid Artery Diseases - diagnosis
Carotid Artery Diseases - pathology
Circle of Willis - diagnostic imaging
Circle of Willis - pathology
collateral
Female
Humans
ischemic stroke
Magnetic Resonance Angiography
Male
Neurology
Radiography
Retrospective Studies
Risk Factors
Tomography Scanners, X-Ray Computed
Ultrasonography
White Matter - diagnostic imaging
White Matter - pathology
White matter lesions
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cited_by cdi_FETCH-LOGICAL-c529t-34761916f376086145d6310ee761e386b8f7765351a4851722433772cb9069c93
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container_end_page 1754
container_issue 8
container_start_page 1749
container_title Journal of stroke and cerebrovascular diseases
container_volume 24
creator Li, Hua, MD
Xiong, Yunyun, MD, PhD
Xu, Gelin, MD
Zhang, Renliang, MD
Zhu, Wusheng, MD
Yin, Qin, MB
Ma, Minmin, MD
Fan, Xiaobing, MM
Yang, Fang, MD
Liu, Wenhua, MD
Duan, Zuowei, MM
Liu, Xinfeng, MD
description Background The correlation between cerebral atherosclerosis and white matter lesions (WMLs) in the elderly was controversial in the published articles, where the stenosis was often evaluated by ultrasonography, computed tomography angiography, or magnetic resonance angiography and collaterals were seldom considered. We hypothesized that collaterals influence WMLs. Our study was to explore the relationship between the circle of Willis and WMLs in a retrospective, hospital-based cohort of patients with carotid atherosclerosis. Methods Two hundred eighty-six patients with carotid atherosclerosis were enrolled from the Nanjing Stroke Registry. They underwent magnetic resonance imaging evaluating WMLs and digital subtraction angiography evaluating both carotid atherosclerosis and collateral capacity of the circle of Willis. We tested the association between severe carotid atherosclerosis, the circle of Willis, and WMLs by logistic regression analysis. Results Severity of carotid atherosclerosis was not significantly associated with either periventricular or deep WMLs ( P  = .656 and .566, respectively). Number of carotid arteries with severe stenosis was not associated with the severity of either periventricular or deep WMLs ( P  = .721 and .263, respectively). Patency of the communicating arteries (CoA) was not associated with periventricular or deep WMLs ( P  = .561 and .703, respectively). Advanced age and hypertension were associated with periventricular WMLs ( P  = .001 and .008, respectively). Advanced age, hypertension, and prior stroke were associated with deep WMLs ( P  = .049, .048, and .001, respectively). Conclusions The circle of Willis and severe carotid atherosclerosis may not be related to WMLs. Further larger studies are warranted to confirm or refute our findings.
doi_str_mv 10.1016/j.jstrokecerebrovasdis.2015.03.048
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We hypothesized that collaterals influence WMLs. Our study was to explore the relationship between the circle of Willis and WMLs in a retrospective, hospital-based cohort of patients with carotid atherosclerosis. Methods Two hundred eighty-six patients with carotid atherosclerosis were enrolled from the Nanjing Stroke Registry. They underwent magnetic resonance imaging evaluating WMLs and digital subtraction angiography evaluating both carotid atherosclerosis and collateral capacity of the circle of Willis. We tested the association between severe carotid atherosclerosis, the circle of Willis, and WMLs by logistic regression analysis. Results Severity of carotid atherosclerosis was not significantly associated with either periventricular or deep WMLs ( P  = .656 and .566, respectively). Number of carotid arteries with severe stenosis was not associated with the severity of either periventricular or deep WMLs ( P  = .721 and .263, respectively). Patency of the communicating arteries (CoA) was not associated with periventricular or deep WMLs ( P  = .561 and .703, respectively). Advanced age and hypertension were associated with periventricular WMLs ( P  = .001 and .008, respectively). Advanced age, hypertension, and prior stroke were associated with deep WMLs ( P  = .049, .048, and .001, respectively). Conclusions The circle of Willis and severe carotid atherosclerosis may not be related to WMLs. Further larger studies are warranted to confirm or refute our findings.</description><identifier>ISSN: 1052-3057</identifier><identifier>EISSN: 1532-8511</identifier><identifier>DOI: 10.1016/j.jstrokecerebrovasdis.2015.03.048</identifier><identifier>PMID: 26096317</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; atherosclerosis ; Cardiovascular ; Carotid Artery Diseases - diagnosis ; Carotid Artery Diseases - pathology ; Circle of Willis - diagnostic imaging ; Circle of Willis - pathology ; collateral ; Female ; Humans ; ischemic stroke ; Magnetic Resonance Angiography ; Male ; Neurology ; Radiography ; Retrospective Studies ; Risk Factors ; Tomography Scanners, X-Ray Computed ; Ultrasonography ; White Matter - diagnostic imaging ; White Matter - pathology ; White matter lesions</subject><ispartof>Journal of stroke and cerebrovascular diseases, 2015-08, Vol.24 (8), p.1749-1754</ispartof><rights>National Stroke Association</rights><rights>2015 National Stroke Association</rights><rights>Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c529t-34761916f376086145d6310ee761e386b8f7765351a4851722433772cb9069c93</citedby><cites>FETCH-LOGICAL-c529t-34761916f376086145d6310ee761e386b8f7765351a4851722433772cb9069c93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26096317$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Hua, MD</creatorcontrib><creatorcontrib>Xiong, Yunyun, MD, PhD</creatorcontrib><creatorcontrib>Xu, Gelin, MD</creatorcontrib><creatorcontrib>Zhang, Renliang, MD</creatorcontrib><creatorcontrib>Zhu, Wusheng, MD</creatorcontrib><creatorcontrib>Yin, Qin, MB</creatorcontrib><creatorcontrib>Ma, Minmin, MD</creatorcontrib><creatorcontrib>Fan, Xiaobing, MM</creatorcontrib><creatorcontrib>Yang, Fang, MD</creatorcontrib><creatorcontrib>Liu, Wenhua, MD</creatorcontrib><creatorcontrib>Duan, Zuowei, MM</creatorcontrib><creatorcontrib>Liu, Xinfeng, MD</creatorcontrib><title>The Circle of Willis and White Matter Lesions in Patients with Carotid Atherosclerosis</title><title>Journal of stroke and cerebrovascular diseases</title><addtitle>J Stroke Cerebrovasc Dis</addtitle><description>Background The correlation between cerebral atherosclerosis and white matter lesions (WMLs) in the elderly was controversial in the published articles, where the stenosis was often evaluated by ultrasonography, computed tomography angiography, or magnetic resonance angiography and collaterals were seldom considered. We hypothesized that collaterals influence WMLs. Our study was to explore the relationship between the circle of Willis and WMLs in a retrospective, hospital-based cohort of patients with carotid atherosclerosis. Methods Two hundred eighty-six patients with carotid atherosclerosis were enrolled from the Nanjing Stroke Registry. They underwent magnetic resonance imaging evaluating WMLs and digital subtraction angiography evaluating both carotid atherosclerosis and collateral capacity of the circle of Willis. We tested the association between severe carotid atherosclerosis, the circle of Willis, and WMLs by logistic regression analysis. Results Severity of carotid atherosclerosis was not significantly associated with either periventricular or deep WMLs ( P  = .656 and .566, respectively). Number of carotid arteries with severe stenosis was not associated with the severity of either periventricular or deep WMLs ( P  = .721 and .263, respectively). Patency of the communicating arteries (CoA) was not associated with periventricular or deep WMLs ( P  = .561 and .703, respectively). Advanced age and hypertension were associated with periventricular WMLs ( P  = .001 and .008, respectively). Advanced age, hypertension, and prior stroke were associated with deep WMLs ( P  = .049, .048, and .001, respectively). Conclusions The circle of Willis and severe carotid atherosclerosis may not be related to WMLs. Further larger studies are warranted to confirm or refute our findings.</description><subject>Aged</subject><subject>atherosclerosis</subject><subject>Cardiovascular</subject><subject>Carotid Artery Diseases - diagnosis</subject><subject>Carotid Artery Diseases - pathology</subject><subject>Circle of Willis - diagnostic imaging</subject><subject>Circle of Willis - pathology</subject><subject>collateral</subject><subject>Female</subject><subject>Humans</subject><subject>ischemic stroke</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>Neurology</subject><subject>Radiography</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Tomography Scanners, X-Ray Computed</subject><subject>Ultrasonography</subject><subject>White Matter - diagnostic imaging</subject><subject>White Matter - pathology</subject><subject>White matter lesions</subject><issn>1052-3057</issn><issn>1532-8511</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNqVkU-LFDEQxYMo7h_9CpKjCN2mOp2k-yKsg7rCiIKrewyZdDWT3p7Omsqs7Lc3w6wexIuXJBQvr6p-j7FXIGoQoF9P9UQ5xRv0mHCT4p2jIVDdCFC1kLVou0fsFJRsqk4BPC5voZpKCmVO2BnRJASA6tRTdtJo0WsJ5pR9v9oiX4XkZ-Rx5NdhngNxtwz8ehsy8k8uZ0x8jRTiQjws_IvLAZdM_GfIW75yKeYw8Iu8xRSp2JQz0DP2ZHQz4fOH-5x9e__uanVZrT9_-Li6WFdeNX2uZGs09KBHabToNLRqKGMJxFJG2elNNxqjlVTg2rKTaZpWSmMav-mF7n0vz9nLo-9tij_2SNnuAnmcZ7dg3JMFI2T504Io0rdHqS8TUsLR3qawc-negrAHvnay_-JrD3ytkLbwLSYvHvrtNzsc_lj8BloE66MAy9Z3AZMlX3B5HEJCn-0Qw__1e_OXnZ_DErybb_AeaYr7tBS-Fiw1Vtivh8QPgYMqYXetlr8AMeGtDA</recordid><startdate>20150801</startdate><enddate>20150801</enddate><creator>Li, Hua, MD</creator><creator>Xiong, Yunyun, MD, PhD</creator><creator>Xu, Gelin, MD</creator><creator>Zhang, Renliang, MD</creator><creator>Zhu, Wusheng, MD</creator><creator>Yin, Qin, MB</creator><creator>Ma, Minmin, MD</creator><creator>Fan, Xiaobing, MM</creator><creator>Yang, Fang, MD</creator><creator>Liu, Wenhua, MD</creator><creator>Duan, Zuowei, MM</creator><creator>Liu, Xinfeng, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150801</creationdate><title>The Circle of Willis and White Matter Lesions in Patients with Carotid Atherosclerosis</title><author>Li, Hua, MD ; 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We hypothesized that collaterals influence WMLs. Our study was to explore the relationship between the circle of Willis and WMLs in a retrospective, hospital-based cohort of patients with carotid atherosclerosis. Methods Two hundred eighty-six patients with carotid atherosclerosis were enrolled from the Nanjing Stroke Registry. They underwent magnetic resonance imaging evaluating WMLs and digital subtraction angiography evaluating both carotid atherosclerosis and collateral capacity of the circle of Willis. We tested the association between severe carotid atherosclerosis, the circle of Willis, and WMLs by logistic regression analysis. Results Severity of carotid atherosclerosis was not significantly associated with either periventricular or deep WMLs ( P  = .656 and .566, respectively). Number of carotid arteries with severe stenosis was not associated with the severity of either periventricular or deep WMLs ( P  = .721 and .263, respectively). Patency of the communicating arteries (CoA) was not associated with periventricular or deep WMLs ( P  = .561 and .703, respectively). Advanced age and hypertension were associated with periventricular WMLs ( P  = .001 and .008, respectively). Advanced age, hypertension, and prior stroke were associated with deep WMLs ( P  = .049, .048, and .001, respectively). Conclusions The circle of Willis and severe carotid atherosclerosis may not be related to WMLs. Further larger studies are warranted to confirm or refute our findings.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26096317</pmid><doi>10.1016/j.jstrokecerebrovasdis.2015.03.048</doi><tpages>6</tpages></addata></record>
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1532-8511
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subjects Aged
atherosclerosis
Cardiovascular
Carotid Artery Diseases - diagnosis
Carotid Artery Diseases - pathology
Circle of Willis - diagnostic imaging
Circle of Willis - pathology
collateral
Female
Humans
ischemic stroke
Magnetic Resonance Angiography
Male
Neurology
Radiography
Retrospective Studies
Risk Factors
Tomography Scanners, X-Ray Computed
Ultrasonography
White Matter - diagnostic imaging
White Matter - pathology
White matter lesions
title The Circle of Willis and White Matter Lesions in Patients with Carotid Atherosclerosis
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