Abstract Details

Title Fetal Type Posterior Cerebral Circulation Influence Stroke Characteristics

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P04 - (-)

Poster/Presentation
Number 070

Objective

Background BACKGROUND: fPCA is a common variant of cerebral circulation which limits collateral flow and increases the volume of tissue perfused by the anterior circulation. Patients with fPCA may be predisposed to have occlusion of particular vessels, unique distribution of stroke etiology, and have worse outcome. Few studies have examined how fPCA impacts patients with AIS.

Design/Methods DESIGN/METHODS: A retrospective review of prospectively identified patients with AIS from 7/2008-12/2010 was performed. Patients without intracranial vascular imaging were excluded. We defined fPCA as complete absence of a P1 segment linking the basilar with the PCA. We compared patients with fPCA and patients without fPCA in terms of demographics, stroke severity (NIHSS), distribution and etiology, and outcome.

Results RESULTS: Of the 535 patients with AIS and intracranial vascular imaging, 9.5% (n=51) had fPCA. Compared with AIS patients without fPCA, those with fPCA were older (74 vs 62; p=0.006) and more often female (60.8% vs 39.5%; p=0.003). Stroke severity, length of stay, discharge mRS, discharge NIHSS and vascular distribution were similar. Patients with fPCA had significant variation in TOAST classification (p=0.004). When patients with fPCA ipsilateral to the stroke (n=28) were compared to all others, there were more large vessel events and posterior circulation was involved more often (35.7% vs 17.6%; p=0.016).

Conclusions CONCLUSIONS: Patients with fPCA had more large vessel and less small vessel strokes. There was a trend towards more PCA involvement and significantly more posterior circulation involvement when the stroke was ipsilateral to a fPCA. The presence of a fPCA may make the posterior circulation more vulnerable to ischemia.

Authors/Disclosures
Amir Shaban, MD (University of Iowa) PRESENTER	Dr. Shaban has nothing to disclose.
	No disclosure on file
Karen C. Albright, DO, DO, PhD, MS, MPH (FDA)	Dr. Albright has nothing to disclose.
Amelia K. Boehme, PhD (Columbia University)	Dr. Boehme has nothing to disclose.
Sheryl Martin-Schild, MD, PhD, FAAN (Dr. Brain, Inc.)	No disclosure on file

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