Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026
Association between fetal type posterior cerebral artery and internal carotid artery stenosis.
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Zhang Zhao, Chen Aidi, Yang Yujia, Luo Anling, Li Xuzi, Deng Yiting, He Li, Zhou Muke
Аннотация
OBJECTIVES: The internal carotid artery (ICA) serves as the main supply artery in individuals with bilateral complete fetal type posterior cerebral artery (BcFTP), a significant anatomical variation that can impact cerebral blood flow distribution. We aimed to determine whether BcFTP was associated with the occurrence of ICA stenosis.
METHODS: In this observational study, we retrospectively reviewed patients from our comprehensive stroke center whose data were extracted from a prospectively collected digital subtraction angiography (DSA) registry from January 2011 to December 2022. They were classified into the BcFTP group and non-FTP group. The presence of BcFTP and the site and degree of ICA stenosis (evaluated at > 30 % , ≥50 %, and ≥ 70 % thresholds) were determined by two independent neuro-interventionalists blinded to clinical data. To investigate the association between BcFTP and the occurrence of ICA stenosis, a 1:2 ratio propensity score matching (PSM) and conditional logistic regression analysis were conducted.
RESULTS: A total of 9,400 consecutive patients were included in the present study. BcFTP was found in 228 of 9,400 patients (2.4 %). After 1:2 PSM, 228 patients with BcFTP were successfully matched with 456 non-FTP controls. The presence of BcFTP was strongly associated with a significantly lower prevalence of moderate-to-severe (≥50 %) stenosis in both the left ICA (odd ratio [OR] 0.29, 95 % confidence interval [CI] 0.16-0.50, p < 0.001) and right ICA (OR 0.20, 95 % CI 0.11-0.36, p < 0.001). This robust inverse association was consistent across both extracranial and intracranial segments and remained highly significant at the severe (≥70 %) stenosis threshold. In the subgroup analysis stratified by high-risk factors (age, BMI, hypertension, diabetes, hyperlipidemia, and smoking), the association remained significant.
CONCLUSIONS: Our research indicates that BcFTP is independently associated with a lower occurrence of ICA stenosis. While causality cannot be determined, these angiographic findings are hypothesis-generating and suggest that anatomical parameters, along with their hemodynamic consequences, may be an important factor associated with the prevalence of ICA stenosis.
METHODS: In this observational study, we retrospectively reviewed patients from our comprehensive stroke center whose data were extracted from a prospectively collected digital subtraction angiography (DSA) registry from January 2011 to December 2022. They were classified into the BcFTP group and non-FTP group. The presence of BcFTP and the site and degree of ICA stenosis (evaluated at > 30 % , ≥50 %, and ≥ 70 % thresholds) were determined by two independent neuro-interventionalists blinded to clinical data. To investigate the association between BcFTP and the occurrence of ICA stenosis, a 1:2 ratio propensity score matching (PSM) and conditional logistic regression analysis were conducted.
RESULTS: A total of 9,400 consecutive patients were included in the present study. BcFTP was found in 228 of 9,400 patients (2.4 %). After 1:2 PSM, 228 patients with BcFTP were successfully matched with 456 non-FTP controls. The presence of BcFTP was strongly associated with a significantly lower prevalence of moderate-to-severe (≥50 %) stenosis in both the left ICA (odd ratio [OR] 0.29, 95 % confidence interval [CI] 0.16-0.50, p < 0.001) and right ICA (OR 0.20, 95 % CI 0.11-0.36, p < 0.001). This robust inverse association was consistent across both extracranial and intracranial segments and remained highly significant at the severe (≥70 %) stenosis threshold. In the subgroup analysis stratified by high-risk factors (age, BMI, hypertension, diabetes, hyperlipidemia, and smoking), the association remained significant.
CONCLUSIONS: Our research indicates that BcFTP is independently associated with a lower occurrence of ICA stenosis. While causality cannot be determined, these angiographic findings are hypothesis-generating and suggest that anatomical parameters, along with their hemodynamic consequences, may be an important factor associated with the prevalence of ICA stenosis.