Data set from Varga A, Di Leo G, Banga PV, Csobay-Novák C, Kolossváry M, Maurovich-Horvat P, Hüttl K. Multidetector CT angiography of the Circle of Willis: association of its variants with carotid artery disease and brain ischemia. Eur Radiol. 2019 Jan;29(1):46-56. doi: 10.1007/s00330-018-5577-x. Epub 2018 Jun 19. PMID: 29922933; PMCID: PMC6291432.

<p>Data set from the article Data set from Varga A, Di Leo G, Banga PV, Csobay-Nov&aacute;k C, Kolossv&aacute;ry M, Maurovich-Horvat P, H&uuml;ttl K. Multidetector CT angiography of the Circle of Willis: association of its variants with carotid artery disease and brain ischemia. Eur Radiol. 2019 Jan;29(1):46-56. doi: 10.1007/s00330-018-5577-x. Epub 2018 Jun 19. PMID: 29922933; PMCID: PMC6291432.</p> <p>This is the abstract</p> <p><strong>Purpose: </strong> (1) to estimate the prevalence of Circle of Willis (CoW) variants in patients undergoing carotid endarterectomy, (2) to correlate these variants to controls and (3) cerebral ischemia depicted by computed tomography (CT).</p> <p><strong>Materials and methods: </strong> After Institutional Review Board approval, data of 544 carotid endarterectomy patients (331 males, mean age 69&plusmn;8 years) and 196 controls (117 males, mean age 66&plusmn;11 years) who underwent brain CT and carotid CT angiography (CTA) were retrospectively analysed. Two observers independently classified each CoW segment as normal, hypoplastic (diameter &lt;0.8 mm) or non-visualized. Four groups of CoW variants based on the number of hypoplastic/non-visualized segments were correlated with clinical data (ANOVA, &chi;² and multivariate logistic regression analysis). Intra- and inter-observer agreement was estimated using Cohen &kappa; statistics.</p> <p><strong>Results: </strong> High prevalence of CoW variants (97%) and compromised CoW (81%) was observed in the study group and significant difference was found in the distribution of CoW variants compared to controls (p&lt;0.001), internal carotid artery (ICA) stenosis being the only independent predictor of CoW morphology (p&lt;0.001). Significant correlation was found between CoW configuration and brain ischemia in the study group (p=0.002). ICA stenosis of &ge;90% was associated to higher rate of ipsilateral A1 hypoplasia/non-visualization (p&lt;0.001). Intra- and inter-observer agreement was from substantial to almost perfect (Cohen &kappa;=0.75-1.0).</p> <p><strong>Conclusion: </strong> Highly variable CoW morphology was demonstrated in patients undergoing endarterectomy compared to controls. Likely compromised CoW in relation to cerebral ischemia was observed in a large cohort of carotid endarterectomy subjects.</p> <p><strong>Key points: </strong> &bull; CoW variant distribution significantly differed in the study and control groups (p&lt;0.001). &bull; ICA stenosis was the only independent predictor of CoW morphology (p&lt;0.001). &bull; Severely compromised CoW configuration showed significant association with brain ischemia (p=0.002).</p>