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Scripta Scientifica Medica

CT angiographic study of the role of both willis circle and vertebral arteries during selective cerebral perfusion - a study in 105 patients

Vassil Papantchev, V. Stoinova, D. Todorova-Papantcheva, V. Groudeva, A. Paloff, Dimka Hinova-Palova, S. Hristov, A. Aleksandrov, M. Goshev, D. Nikolov, D. Petkov, G. Nachev, W. Ovtscharoff

Abstract

Unilateral selective cerebral perfusion (SCP) is a method for cerebral protection in aortic arch surgery. However, variations of the circle of Willis (CoW) could vitiate its protective effect. The aim of our present work was to prospectively analyze variations of CoW and vertebral arteries using CT angiography. From January, 2008 to July, 2008, a total of 105 consecutive patients underwent CT-angiography of the CoW in the Division of Radiology, St. Ekaterina University Hospital of Sofia. There were at least six CoW configurations that could lead to significant hypo perfusion during unilateral SCP: i) type IA - hypoplasia or absence of left posterior communicating artery (PComA) (in 41.9% of the patients); ii) type IB - hypoplasia or absence of anterior communicating artery (AComA) (in 1.9%); iii) type IIA - hypoplasia or absence of both left PComA and AComA (in 6.67%); iv) type IIB - hypoplasia or absence of left P1 or right vertebral artery (VA) (in 6.67%); v) type III - hypoplasia or absence of right A1 (in 8.57%), and vi) type IV - hypoplasia or absence of both right A1 and right VA or both right A1 and left PComA (in 0.95%). All these types were present in a 66.67% of all the examined patients. Our present study showed that CoW variations are presented in significant number of patients. These results support the need of extensive preoperative examination and meticulous intraoperative monitoring of cerebral perfusion during unilateral SCP.

Scripta Scientifica Medica 2012; 44(2): 73-77.


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DOI: http://dx.doi.org/10.14748/ssm.v44i2.362

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About The Authors

Vassil Papantchev
Medical University of Sofia
Bulgaria

Department of Cardiac SurgeryDepartment of Anatomy and Histology

V. Stoinova
Medical University of Sofia
Bulgaria

Section of Visual Diagnostics, St. Ekaterina University Hospital of Sofia

D. Todorova-Papantcheva
Kliment Ohridski University of Sofia
Bulgaria

Department of General, Experimental and Genetic Psychology

V. Groudeva
Medical University of Sofia
Bulgaria

Section of Visual Diagnostics, St. Ekaterina University Hospital of Sofia

A. Paloff
Medical University of Sofia
Bulgaria

Department of Anatomy and Histology

Dimka Hinova-Palova
Medical University of Sofia
Bulgaria

Department of Anatomy and Histology

S. Hristov
Medical University of Sofia
Bulgaria

Department of Anatomy and Histology

A. Aleksandrov
Medical University of Sofia
Bulgaria

Department of Forensic Medicine

M. Goshev
Medical University of Sofia
Bulgaria

Department of Forensic Medicine

D. Nikolov
Medical University of Sofia
Bulgaria

Department of Forensic Medicine

D. Petkov
Medical University of Sofia
Bulgaria

Department of Cardiac Surgery

G. Nachev
Medical University of Sofia
Bulgaria

Department of Cardiac Surgery

W. Ovtscharoff
Medical University of Sofia
Bulgaria

Department of Anatomy and Histology

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