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The Journal of Cardiovascular Surgery 2002 December;43(6):887-90

language: English

The circle of Willis in healthy older persons

Macchi C. 1, Molino Lova R. 1, Miniati B. 1, Gulisano M. 2, Pratesi C. 3, Conti A. A. 1,4, Gensini G. F. 1,4

1 Depart­ment of Car­di­o­vas­cular Med­i­cine Don ­Gnocchi Foun­da­tion, Flor­ence, ­Italy
2 Department of ­Human ­Anatomy and His­tology,
3 Depart­ment of Vas­cular Sur­gery,
4 Depart­ment of ­Internal Med­i­cine and Car­di­ology, Uni­ver­sity of Flor­ence, ­Italy


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Back­ground. The cur­rent indi­ca­tion for ­carotid sur­gery is ­based ­upon the per­centage of sten­osis of the ­internal ­carotid ­artery. ­This ­approach ­shows ­many lim­i­ta­tions, one of ­which is to pre­sume the ana­tom­ical com­plete­ness of the ­circle of ­Willis in all ­patients who are eval­u­ated. On the con­trary, ­there is ­increasing evi­dence of a ­great nat­ural var­i­ability in the con­fig­u­ra­tion of the ­circle of ­Willis.
­Methods. The aim of the ­present ­paper was to inves­ti­gate, by mag­netic res­o­nance angio­graphy, the var­i­ability of the ­circle of ­Willis in a ­cohort of 118 ­healthy ­older per­sons.
­Results. The ­circle of ­Willis ­showed an ­entirely com­plete con­fig­u­ra­tion in 47% of the sub­jects, a com­plete con­fig­u­ra­tion of its ante­rior ­part in 90% of the sub­jects, and a com­plete con­fig­u­ra­tion of its pos­te­rior ­part in 48.5% of the sub­jects.
Con­clu­sions. ­These find­ings con­firm the ­great var­i­ability of the ­circle of ­Willis ­even in ­healthy ­older per­sons and sug­gest ­that, in indi­cating ­carotid sur­gery, the con­fig­u­ra­tion of the ­circle of ­Willis ­should ­also be ­taken ­into ­account.

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