Background
The correlation between cerebral atherosclerosis and white matter lesions (WMLs) in
the elderly was controversial in the published articles, where the stenosis was often
evaluated by ultrasonography, computed tomography angiography, or magnetic resonance
angiography and collaterals were seldom considered. We hypothesized that collaterals
influence WMLs. Our study was to explore the relationship between the circle of Willis
and WMLs in a retrospective, hospital-based cohort of patients with carotid atherosclerosis.
Methods
Two hundred eighty-six patients with carotid atherosclerosis were enrolled from the
Nanjing Stroke Registry. They underwent magnetic resonance imaging evaluating WMLs
and digital subtraction angiography evaluating both carotid atherosclerosis and collateral
capacity of the circle of Willis. We tested the association between severe carotid
atherosclerosis, the circle of Willis, and WMLs by logistic regression analysis.
Results
Severity of carotid atherosclerosis was not significantly associated with either periventricular
or deep WMLs (P = .656 and .566, respectively). Number of carotid arteries with severe stenosis was
not associated with the severity of either periventricular or deep WMLs (P = .721 and .263, respectively). Patency of the communicating arteries (CoA) was not
associated with periventricular or deep WMLs (P = .561 and .703, respectively). Advanced age and hypertension were associated with
periventricular WMLs (P = .001 and .008, respectively). Advanced age, hypertension, and prior stroke were
associated with deep WMLs (P = .049, .048, and .001, respectively).
Conclusions
The circle of Willis and severe carotid atherosclerosis may not be related to WMLs.
Further larger studies are warranted to confirm or refute our findings.
Key Words
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Article info
Publication history
Published online: June 18, 2015
Accepted:
March 18,
2015
Received in revised form:
January 24,
2015
Received:
October 16,
2014
Footnotes
The authors declare that they have no conflict of interest.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.03.048
Copyright
© 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
