CardioVascular and Interventional Radiology

, Volume 41, Issue 12, pp 1917–1924 | Cite as

Presence of the Posterior Communicating Artery Contributes to the Clinical Outcome After Endovascular Treatment of Patients with MCA Occlusions

  • Benjamin Friedrich
  • Felix Kempf
  • Tobias Boeckh-Behrens
  • Johanna Fischer
  • Manuel Lehm
  • Maria Bernd
  • Silke Wunderlich
  • Sebastian Mönch
  • Claus Zimmer
  • Christian MaegerleinEmail author
Clinical Investigation Stroke/Neurointerventions
Part of the following topical collections:
  1. Stroke/Neurointerventions



In patients with acute occlusions of the middle cerebral artery, the collaterals play an important role in infarct growth and potentially on clinical outcome. As the primary collateral pathway, the posterior cerebral artery with the posterior communicating artery (PComA) is important. We analyzed the influence of the presence of an ipsilateral PComA on infarct growth and clinical outcome.


We included 101 patients with M1 occlusions and subsequent endovascular treatment and differentiated patients without an ipsilateral PComA from those with an ipsilateral PComA.


There was no difference in the rate of successful recanalizations and procedural parameters between both groups. Of the patients with an existing PComA, 51% showed an excellent clinical outcome (90d mRS < 2), but only 28% of the patients without PComA had an excellent clinical outcome (p = 0.02). The presence of an ipsilateral PComA was independently associated with the rate of excellent clinical outcome (aOR 3.9, 95% CI 1.2–9.8; p = 0.021) and lower infarct volume (38 ± 8 cm3 vs. 78 ± 13 cm3, p = 0.032).


The presence of an ipsilateral PComA is a predictor for excellent clinical outcome independently from the technical success of mechanical recanalization. This finding provides insights into the changes of circulation in patients suffering from an acute stroke and underlines the importance of collateralization.


Stroke Anatomy Collateral circulation Endovascular treatment Outcome 



Anterior cerebral artery


Anterior communicating artery


Adjusted Odds Ratio


Alberta Stroke Program Early CT Score


Confidence interval


Computed tomography angiography


Computed tomography perfusion


Digital subtraction angiography


Diffusion-weighted imaging


Internal carotid artery


Large vessel occlusion


Middle cerebral artery


Modified Rankin Scale


Mechanical thrombectomy


Modified Thrombolysis in Cerebral Infarction


National Institute of Health Stroke Scale


Posterior communicating artery


Tissue plasminogen activator


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed Consent

For this type of study, informed consent is not required.

Consent for Publication

For this type of study, consent for publication is not required.

Supplementary material

270_2018_2029_MOESM1_ESM.pdf (311 kb)
Supplementary material 1 (PDF 310 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Benjamin Friedrich
    • 1
  • Felix Kempf
    • 2
  • Tobias Boeckh-Behrens
    • 1
  • Johanna Fischer
    • 1
  • Manuel Lehm
    • 1
  • Maria Bernd
    • 1
  • Silke Wunderlich
    • 3
  • Sebastian Mönch
    • 1
  • Claus Zimmer
    • 1
  • Christian Maegerlein
    • 1
    Email author
  1. 1.Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der IsarTechnical University MunichMunichGermany
  2. 2.Arnold Sommerfeld Center for Theoretical Physics, Department of PhysicsLMU MunichMunichGermany
  3. 3.Department of Neurology, Klinikum rechts der IsarTechnical University MunichMunichGermany

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