The Risk Relationship Between Integrity Of Willis Circle And Intracranial Aneurysm

Objective To evaluate the occurrence and rupture risk of incomplete CoW and IAs through case-control study.Methods Patients diagnosed with IAs in the 94 th hospital of the joint logistics support force of the Chinese people's liberation army(former lanzhou military region general hospital)from January 2015 to December 2018 were randomly selected as the case group,and those hospitalized with non-intracranial aneurysm disease and undergoing head CTA examination from January 2015 to December 2018 were randomly selected as the control group.Subjects' medical history(domicile,residence,gender,age,history of hypertension,diabetes mellitus,smoking history)were recorded according to the unified specifications in accordance with inclusion and exclusion criteria.Cranial CTA images of all subjects were analyzed,and CoW integrity,CoW missing sites,and aneurysm distribution,number,and diameter were counted.First,the chi-square OR t-test was used to screen the relationship between all independent variables and dependent variables.Then,the estimated value of relative risk(OR)and 95% confidence interval(CI)were analyzed according to the major factors in the logistic regression model.The data processing was assisted by SPSS24.0 software.Results A total of 199 aneurysms were involved in 190 cases in this study.The proportion of internal carotid artery and its branches was the highest(33.7%),followed by anterior communicating artery(30.7%)and cerebral middle cerebral artery(19.6%).Among the 190 cases group,55 cases(28.9%)of CoW were incomplete,and the most common one was the absence of PcomA(49.2%),followed by A1 segment of ACAs(26.2%),P1 segment of PCAs(21.3%),and AcomA(3.3%).In the control group of 244 patients,33(13.5%)cases of CoW were incomplete,and the most common absence was PcomA(67.6%),followed by PCAs P1 segment(16.2%),ACAs A1 segment(13.5%),and AcomA(2.4%).After gender and hypertension risk factors were adjusted by logistic regression,incomplete CoW was closely related to the incidence of IAs(OR=2.71,95%ci: 1.65-4.43).Further multivariate analysis showed that there was no significant correlation between incomplete CoW and intracranial aneurysm rupture.The distribution of IAs was correlated with rupture.The IAs in the previous circulation was the control,and the IAs in the traffic artery(OR=1.84,95%ci: 1.02-3.31)and the posterior circulation(OR=1.18,95%ci: 0.22-6.20)had relatively high rupture risk.Conclusion Incomplete CoW is related to the occurrence of IAs.Incomplete CoW increases the incidence of IAs and is a risk factor for the occurrence of IAs.There was no obvious correlation between incomplete CoW and IAs rupture.