Reperfusion Therapy in Patients with Acute Stroke with the Willis Polygon Variant – A Fetal Posterior Cerebral Artery

A BSTRACT Aim: The Willis polygon variant, specifically the presence of a fetal posterior cerebral artery (fPCA), can have implications for the treatment and prognosis of patients with acute stroke. This study aimed to investigate the effect of fPCA variations on treatment, follow-up, and prognosis in patients with acute stroke who underwent reperfusion therapies. Materials and Methods: The study analyzed a total of 62 patients, including 33 without any posterior system variant (normal group) and 29 with only the fPCA variant (variant group). Demographic characteristics, clinical features, and computed tomography (CT) findings were compared between the two groups. Treatment methods, acute stroke therapies, and clinical outcomes were evaluated. Results: No significant differences were observed in age, sex, smoking status, or comorbidities between the normal and fPCA groups. Cardiac parameters were similar between the groups. Treatment approaches, artery territories, acute stroke therapies, and time intervals did not differ significantly between the two groups. The National Institutes of Health Stroke Scale scores, modified Rankin Scale scores, and CT findings were also similar between the groups. A significant difference was observed in the presence of hemorrhage at 24 h, with higher rates in the normal group. Conclusion: The presence of fPCA does not significantly influence age-related risk factors or comorbidities in patients with acute stroke. Treatment approaches and clinical outcomes were similar regardless of the presence of fPCA, except for a higher risk of hemorrhage in the normal group. The lateral status of the variants did not significantly impact the distribution of risk scores and CT findings.