Figure 2
From: Predictors and prognoses of Willisian collateral failure during mechanical thrombectomy
An example of dynamic Willisian collateral failure during endovascular therapy. (A) Preprocedural imaging reveals preservation of the Willisian collaterals by the anterior communicating artery (yellow arrow) and shows a small infarct volume. (B) Angiography of the contralateral ICA, before the procedure, confirms the patency of the leptomeningeal collaterals of the ipsilateral anterior cerebral artery (blue triangle). During the procedure, DWF occurs, and a new embolization into the A2 segment of the ACA (orange arrowheads) abruptly resulting in a near-complete leptomeningeal collateral shutdown. (C) Despite complete reperfusion achieved on final angiography, a large final infarct volume was induced, due to DWF, which was associated with poor outcomes. ACA, anterior cerebral artery; DWF, dynamic Willisian collateral failure; EVT, endovascular treatment; ICA, internal carotid artery; MCA, middle cerebral artery; mRS, modified Rankin Scale; mTICI, modified thrombolysis in cerebral ischemia.
