Internal carotid and vertebral arteries diameters and their interrelationships to sex and left/right side

• Autorzy: Spasojevic G. , Vujmilovic S. , Vujkovic Z. , Gajanin R. , Malobabic S. , Ponorac N. , Preradovic L.
• Języki publikacji: EN

Abstrakty

EN

Background: The available anatomical data about diameters of inflow vessels to the circle of Willis reflect various diagnostic and imaging methods used, sample sizes, levels of measurements, and lack of possible specific ethnic, regional or genetic data. Additionally, the data are often without distinctions about left-right or sex. Materials and methods: Therefore, using computed tomography angiography (CTA) we investigated diameters of internal carotid (ICA) and vertebral (VA) arteries in 70 adult persons (28–75 years) of both sexes (34 males and 36 females), at predefined cervical parts of ICA (2 cm above carotid bifurcation) and of VA (5 mm before VA penetrated the dura). Results: Sex differences were expressed as highly significant larger diameters of left VA (LVA) in males (3.49 mm) than in females (3.00 mm), and as significantly larger diameters of right VA (RVA) in males (3.20 mm) than in females (2.82 mm), as well as of right ICA (RICA) diameters in males (5.04 mm) than in females (4.56 mm), but without such difference for left ICA (LICA) between males (4.82 mm) and females (4.60 mm). Intrasex (in males or in females) left-right differences of ICA and VA diameters were not significant. Significant positive correlations were found in females between RICA and RVA, and in males between RICA and LICA. Calculated mean sum of ipsilateral diameters of right arteries (RAA = RICA + RVA) was in males 8.25 mm, in females 7.38 mm, and of left arteries (LAA = LICA + LVA) was in males 8.31, and in females 7.60 mm, without statistically significant difference between RAA and LAA, neither in males, nor in females. Statistically highly significant larger sums of diameters were in males than in females for both, RAA and LAA. Conclusions: Our findings, as the first data about diameters of ICA and VA systematically obtained by CTA in the population of western Balkans, suggest that in the studies of these diameters is absolutely necessary to analyse separately the data for sex, and to use defined standard levels. (Folia Morphol 2020; 79, 2: 219–225)

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2020
• Tom: 79
• Numer: 2
• Opis fizyczny: p.219-225,fig.,ref.

Twórcy

autor

Spasojevic G.

• Department of Anatomy, Faculty of Medicine, University of Banja Luka, Bosnia and Herzegovina

autor

Vujmilovic S.

• Department of Radiology, Faculty of Medicine, University Clinical Centre of Republic Srpska, University of Banja Luka, Bosnia and Herzegovina

autor

Vujkovic Z.

• Neurology Clinic, Faculty of Medicine, University Clinical Centre of Republic Srpska, University of Banja Luka, Bosnia and Herzegovina

autor

Gajanin R.

• Department of Pathology, Faculty of Medicine, University Clinical Centre of Republic of Srpska, University of Banja Luka, Bosnia and Herzegovina

autor

Malobabic S.

• Institute of Anatomy Dr. Niko Miljanic, Faculty of Medicine, University of Belgrade, Serbia

autor

Ponorac N.

• Department of Physiology, Faculty of Medicine, University of Banja Luka, Bosnia and Herzegovina

autor

Preradovic L.

• Informatic in Medicine, Faculty of Medicine, University of Banja Luka, Bosnia and Herzegovina

Bibliografia

• 1. Amin-Hanjani S, Du X, Pandey DK, et al. Effect of age and vascular anatomy on blood flow in major cerebral vessels. J Cereb Blood Flow Metab. 2015; 35(2): 312–318, doi: 10.1038/jcbfm.2014.203, indexed in Pubmed: 25388677.
• 2. Anzola GP, Gasparotti R, Magoni M, et al. Transcranial Doppler sonography and magnetic resonance angiography in the assessment of collateral hemispheric flow in patients with carotid artery disease. Stroke. 1995; 26(2): 214–217, doi: 10.1161/01.str.26.2.214, indexed in Pubmed: 7831690.
• 3. Bender M, Olivi A, Tamargo RJ. Iulius Casserius and the first anatomically correct depiction of the circulus arteriosus cerebri (of Willis). World Neurosurg. 2013; 79(5-6): 791–797, doi: 10.1016/j.wneu.2011.10.044, indexed in Pubmed: 22120555.
• 4. Bogdanović D, Marinković S, Malobabić S. Morfološke varijacije zadnjeg segmenta Willis-ovog kruga i njihov značaj. (Morphological variations of the posterior part of cicrcle of Willis and their significance). Folia Anatomica Iugoslavica, 1978; VII: 81-88. (In Serbian).
• 5. Chao AC, Chu WF, Mu Huo Teng M, et al. The Relationship between Carotid Artery Diameter and Percentage of Stenosis. Neuroradiol J. 2007; 20(1): 103–109, doi: 10.1177/197140090702000117, indexed in Pubmed: 24299598.
• 6. Dadmehr M, Behbahani FA, Bahrami M, et al. Response to: Joveini (Al-Akhawayni) and the early knowledge on Circle of Willis. Int J Cardiol. 2017; 234: 119–120, doi: 10.1016/j.ijcard.2016.12.032, indexed in Pubmed: 28073657.
• 7. Dalca AV, Sridharan R, Sabuncu MR, et al. Predictive Modeling of Anatomy with Genetic and Clinical Data. Med Image Comput Comput Assist Interv. 2015; 9351: 519–526, doi: 10.1007/978-3-319-24574-4_62, indexed in Pubmed: 26855978.
• 8. Eftekhar B, Dadmehr M, Ansari S, et al. Are the distributions of variations of circle of Willis different in different populations? Results of an anatomical study and review of literature. BMC Neurol. 2006; 6: 22, doi: 10.1186/1471-2377-6-22, indexed in Pubmed: 16796761.
• 9. Elwertowski M, Leszczyński J, Kaszczewski P, et al. The importance of blood flow volume in the brain-supplying arteries for the clinical management: the impact of collateral circulation. J Ultrason. 2018; 18(73): 112–119, doi: 10.15557/JoU.2018.0016, indexed in Pubmed: 30335919.
• 10. Ergun O, Gunes Tatar I, Birgi E, et al. Evaluation of vertebral artery dominance, hypoplasia and variations in the origin: angiographic study in 254 patients. Folia Morphol. 2016; 75(1): 33–37, doi: 10.5603/FM.a2015.0061, indexed in Pubmed: 26365867.
• 11. Hendrikse J, Hartkamp MJ, Hillen B, et al. Collateral ability of the circle of Willis in patients with unilateral internal carotid artery occlusion: border zone infarcts and clinical symptoms. Stroke. 2001; 32(12): 2768–2773, doi: 10.1161/hs1201.099892, indexed in Pubmed: 11739971.
• 12. Jensen-Urstad K, Johansson J, Jensen-Urstad M. Vascular function correlates with risk factors for cardiovascular disease in a healthy population of 35-year-old subjects. J Intern Med. 1997; 241(6): 507–513, doi: 10.1111/j.1365-2796.1997.tb00009.x, indexed in Pubmed: 10497627.
• 13. Kamath S. Observations on the length and diameter of vessels forming the circle of Willis. J Anat. 1981; 133(Pt 3): 419–423, indexed in Pubmed: 7328048.
• 14. Kamenskiy AV, Pipinos II, Carson JS, et al. Age and disease-related geometric and structural remodeling of the carotid artery. J Vasc Surg. 2015; 62(6): 1521–1528, doi: 10.1016/j.jvs.2014.10.041, indexed in Pubmed: 25499709.
• 15. Kellawan JM, Harrell JW, Roldan-Alzate A, et al. Regional hypoxic cerebral vasodilation facilitated by diameter changes primarily in anterior versus posterior circulation. J Cereb Blood Flow Metab. 2017; 37(6): 2025–2034, doi: 10.1177/0271678X16659497, indexed in Pubmed: 27406213.
• 16. Klimek-Piotrowska W, Kopeć M, Kochana M, et al. Configurations of the circle of Willis: a computed tomography angiography based study on a Polish population. Folia Morphol. 2013; 72(4): 293–299, doi: 10.5603/fm.2013.0049, indexed in Pubmed: 24402749.
• 17. Kluytmans M, van der Grond J, van Everdingen KJ, et al. Cerebral hemodynamics in relation to patterns of collateral flow. Stroke. 1999; 30(7): 1432–1439, doi: 10.1161/01.str.30.7.1432, indexed in Pubmed: 10390319.
• 18. Krejza J, Arkuszewski M, Kasner SE, et al. Carotid artery diameter in men and women and the relation to body and neck size. Stroke. 2006; 37(4): 1103–1105, doi: 10.1161/01.STR.0000206440.48756.f7, indexed in Pubmed: 16497983.
• 19. Labropoulos N, Zarge J, Mansour MA, et al. Compensatory arterial enlargement is a common pathobiologic response in early atherosclerosis. Am J Surg. 1998; 176(2): 140–143, doi: 10.1016/s0002-9610(98)00135-4, indexed in Pubmed: 9737619.
• 20. Larena-Avellaneda A. „Only size (diameter) does matter“ – Stellen wir bei der asymptomatischen Karotis-interna-Stenose die richtigen Fragen? Gefässchirurgie. 2017; 22(1): 6–9, doi: 10.1007/s00772-016-0239-2.
• 21. Lehrer HZ. Relative calibre of the cervical internal carotid artery. Normal variation with the circle of Willis. Brain. 1968; 91(2): 339–348, doi: 10.1093/brain/91.2.339, indexed in Pubmed: 5721934.
• 22. Lovrencić-Huzjan A, Demarin V, Bosnar M, et al. Color Doppler flow imaging (CDFI) of the vertebral arteries — the normal appearance, normal values and the proposal for the standards. Coll Antropol. 1999; 23(1): 175–181, indexed in Pubmed: 10402720.
• 23. Musicki K, Hurst K, Molnár Z, et al. Cerebral cross-perfusion and the Circle of Willis: does physiology trump anatomy? J Vasc Diagn Interven. 2017; 5: 35–40, doi: 10.2147/jvd.s121839.
• 24. Nicolau C, Gilabert R, García A, et al. Effect of internal carotid artery occlusion on vertebral artery blood flow: a duplex ultrasonographic evaluation. J Ultrasound Med. 2001; 20(2): 105–111, doi: 10.7863/jum.2001.20.2.105, indexed in Pubmed: 11211130.
• 25. Olin JW, Fonseca C, Childs MB, et al. The natural history of asymptomatic moderate internal carotid artery stenosis by duplex ultrasound. Vasc Med. 1998; 3(2): 101–108, doi: 10.1177/1358836X9800300203, indexed in Pubmed: 9796072.
• 26. Ozdemir H, Artaş H, Serhatlioğlu S, et al. Effects of overweight on luminal diameter, flow velocity and intima-media thickness of carotid arteries. Diagn Interv Radiol. 2006; 12(3): 142–146, indexed in Pubmed: 16972220.
• 27. Rai AT, Hogg JP, Cline B, et al. Cerebrovascular geometry in the anterior circulation: an analysis of diameter, length and the vessel taper. J Neurointerv Surg. 2013; 5(4): 371–375, doi: 10.1136/neurintsurg-2012-010314, indexed in Pubmed: 22490430.
• 28. Rogers L. The function of the circulus arteriosus of Willis. Brain. 1947; 70(Pt 2): 171–178, doi: 10.1093/brain/70.2.171, indexed in Pubmed: 20261819.
• 29. Schimansky S, Patel S, Rahal J, et al. Extradural internal carotid artery caliber dysregulation is associated with cerebral aneurysms. Stroke. 2013; 44(12): 3561–3564, doi: 10.1161/STROKEAHA.113.001762, indexed in Pubmed: 24092552.
• 30. Spasojević G, Vujnović S, Ponorac N, et al. Sex and level differences in the diameters of extradural segment of vertebral artery: CT angiographic study. Folia Morphol. 2018; 77(4): 687–692, doi: 10.5603/FM.a2018.0036, indexed in Pubmed: 29651795.
• 31. Stoberock K, Debus ES, Atlihan G, et al. Gender differences in patients with carotid stenosis. Vasa. 2016; 45(1): 11–16, doi: 10.1024/0301-1526/a000490, indexed in Pubmed: 26986705.
• 32. Stojanović N, Stefanović I, Kostić A, et al. Analysis of the symmetric configuration of the circle of Willis in a series of autopsied corpses. Vojnosanit Pregl. 2015; 72(4): 356–360, doi: 10.2298/vsp1504356s, indexed in Pubmed: 26040182.
• 33. Tetiker H, Çimen M, Kosar M. Evaluation of the vertebral artery by 3D digital subtraction angiography. Int J Morphol. 2014; 32(3): 798–802, doi: 10.4067/s0717-95022014000300010.
• 34. Urbanski PP, Lenos A, Blume JC, et al. Does anatomical completeness of the circle of Willis correlate with sufficient cross-perfusion during unilateral cerebral perfusion? Eur J Cardiothorac Surg. 2008; 33(3): 402–408, doi: 10.1016/j.ejcts.2007.12.021, indexed in Pubmed: 18249127.
• 35. Usai S, Caputi L, Ciceri E, et al. Caliber fluctuations of cervical internal carotid artery and migraine with aura: a possible vasospasm detected by ultrasonographic examinations. Headache. 2009; 49(7): 1068–1072, doi: 10.1111/j.1526-4610.2009.01433.x, indexed in Pubmed: 19438731.
• 36. Vasović L, Trandafilović M, Jovanović I, et al. Morphology of the cerebral arterial circle in the prenatal and postnatal period of Serbian population. Childs Nerv Syst. 2013; 29(12): 2249–2261, doi: 10.1007/s00381-013-2151-3, indexed in Pubmed: 23702737.
• 37. Williams MA, Nicolaides AN. Predicting the normal dimensions of the internal and external carotid arteries from the diameter of the common carotid. Eur J Vasc Surg. 1987; 1(2): 91–96, doi: 10.1016/s0950-821x(87)80004-x, indexed in Pubmed: 3503020.
• 38. Windle BC. The arteries forming the circle of Willis. J Anat Physiol. 1888; 22(Pt 2): 289–293, indexed in Pubmed: 17231742.
• 39. World Medical Association Declaration Of Helsinki: Ethical Principles for Medical Research Involving Human Subjects, 64th WMA General Assembly, Fortaleza, Brazil, October 2013. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/.
• 40. Yeniçeri IÖ, Çullu N, Deveer M, et al. Circle of Willis variations and artery diameter measurements in the Turkish population. Folia Morphol. 2017; 76(3): 420–425, doi: 10.5603/FM.a2017.0004, indexed in Pubmed: 28150270.
• 41. Zarrinkoob L, Birgander R, Eklund A, et al. Blood flow distribution in cerebral arteries. J Cereb Blood Flow Metab. 2015; 35(4): 648–654, doi: 10.1038/jcbfm.2014.241, indexed in Pubmed: 25564234.

Identyfikatory

DOI

10.5603/FM.a2019.0071