[Study of the circle of Willis with digital angiography. Contribution to the detection of high-risk carotid clamping].
Radiological studies of Willis' circle morphology are mainly performed in search of intracerebral aneurysms, and for this purpose digital imaging has not superseded conventional radiology. In contrast, conventional imaging does not seem to have given satisfactory results in the functional study of this substitute vascular network, and it is in this field that digital angiography is of particular value. Between January, 1985 and June, 1986, we performed 300 digital angiographies of the supra-aortic vessels in patients with carotid artery stenosis. Each exploration included a stage of investigation for intracranial substitute vessels by compression of the carotid artery on the side of the lesion. Substitute vessels were found to be adequate in 93 p. 100 of the cases. The test showed that there was no alternative blood flow in 3.7 p. 100 of the cases, which made it imperative to use brain protection measures during clamping of the carotid artery. The substitute network was found to be insufficient in 1 p. 100 of the cases, and the method failed in 2.4 p. 100.
Fermand
M
M
Département de Radiologie vasculaire, Hôpital Saint-Joseph, Paris.
Melki
J P
JP
Chaufour
J
J
Riche
M C
MC
D002339:Carotid Arteries; D002533:Cerebral Angiography; D003097:Collateral Circulation; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D006439:Hemodynamics; D006801:Humans; D012307:Risk Factors; D013382:Subtraction Technique
Exploration du polygone de Willis par angiographie numérisée. Apport au dépistage des clampages carotidiens à risque.