Clinical significance of common-stem lenticulostriate arteries in patients with internal watershed infarction

Background A common-stem origin of lenticulostriate arteries (CS-LSAs) is an anatomical variation that supplies a moderate to large section of the basal ganglia. We hypothesized that CS-LSAs with a patent orifice are located at distal positions of the acute-occluded middle cerebral artery (MCA) and...

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Published in:Neurological sciences 2019-11, Vol.40 (11), p.2303-2309
Main Authors: Chen, Wen -huo, Yi, Ting-yu, Zhan, A-lai, Wu, Yan-min, Zhang, Mei-fang, Li, Yi-min, Lu, Yan-yu, Lin, Ding-lai, Lin, Xiao-hui, Pan, Zhi-nan
Format: Article
Language:English
Subjects:
Aged
Angiography, Digital Subtraction
Basal ganglia
Basal Ganglia - blood supply
Basal Ganglia - diagnostic imaging
Basal Ganglia Cerebrovascular Disease - diagnostic imaging
Basal Ganglia Cerebrovascular Disease - mortality
Blood flow
Cardiovascular system
Carotid arteries
Cerebral blood flow
Cerebral Infarction - diagnostic imaging
Cerebral Infarction - mortality
Clinical significance
Diffusion Magnetic Resonance Imaging
Female
Humans
Infarction
Infarction, Middle Cerebral Artery - diagnostic imaging
Infarction, Middle Cerebral Artery - mortality
Ischemia
Male
Medicine
Medicine & Public Health
Middle Aged
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Original Article
Patients
Psychiatry
Retrospective Studies
Stroke
Veins & arteries
Watersheds
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Summary:Background A common-stem origin of lenticulostriate arteries (CS-LSAs) is an anatomical variation that supplies a moderate to large section of the basal ganglia. We hypothesized that CS-LSAs with a patent orifice are located at distal positions of the acute-occluded middle cerebral artery (MCA) and that the blood flow of CS-LSAs is supplied by pail arterial anastomoses and results in hypoperfusion of CS-LSAs, similar to a deep watershed (DWS) infarction. Objective Our study evaluated the possibility of CS-LSAs in patients with DWS infarction and MCA occlusion and also assessed the safety of endovascular therapy (ET) in these patients. Methods A cohort of consecutive patients with DWS infarction and MCA occlusion and in whom full recanalization via ET was achieved were identified. Patients were divided into two groups based on the presence of CS-LSAs observed during ET. In addition, radiological and clinical data were retrospectively analyzed. Results Thirty-three patients were included, and CS-LSAs were observed in 48.5% (16/33) of patients. The possibility (72.2%, 13/18) of CS-LSAs was high in patients with DWS infarction companied with basal ganglia infarction. A good clinical outcome was similar in patients with CS-LSAs and basal ganglia infarction and in patients without CS-LSAs and basal ganglia infarction (69.2% vs. 81.8%, P  = 0.649). Conclusions The possibility of CS-LSAs was 48.5% in patients with DWS infarction and MCA occlusion, and the revascularization procedure was safe and feasible in these patients despite the moderate-to-large basal ganglia infarction.
ISSN:1590-1874
1590-3478
DOI:10.1007/s10072-019-03953-w