METHODS: A systematic search in Pubmed and EMBASE using predefined criteria, following the PRISMA guidelines was performed. The presence of different CoW anatomical variants and a complete CoW was compared between women and men using an inverse variance weighted random effects meta-analysis to calculate relative risks (RR) with 95% confidence intervals (95% CIs).
RESULTS: Fourteen studies were included reporting on 5478 healthy participants (2511 women, 2967 men). Bilateral fetal type posterior cerebral arteries (RR 2.79; 95%CI 1.65-4.72, I2=0%), and a complete CoW (RR 1.24, 95%CI 1.13-1.36; I2=0%) were more prevalent in women than in men. The variants absence or hypoplasia of one of the anterior cerebral arteries (RR 0.58, 95%CI 0.38-0.88, I2=57%) and hypoplasia or absence of both posterior communicating arteries (RR 0.79, 95%CI 0.71-0.87, I2=0%) were more prevalent in men.
CONCLUSIONS: Several anatomical variations of the CoW are sex dependent, with some variants being more common in women while others in men. Future research should assess how these sex-specific CoW variants relate to the sex-specific occurrence of intracranial aneurysms.
方法:使用预定义标准在Pubmed和EMBASE中进行系统搜索,遵循PRISMA指南。使用逆方差加权随机效应荟萃分析在女性和男性之间比较不同CoW解剖变异和完整CoW的存在,以95%置信区间(95%CIs)计算相对风险(RR)。
结果:纳入了14项研究,报告了5478名健康参与者(2511名女性,2967名男子)。双侧胎儿型大脑后动脉(RR2.79;95CI1.65-4.72,I2=0%),完全CoW(RR1.24,95CI1.13-1.36;I2=0%)在女性中比男性更普遍。大脑前动脉之一的变异缺失或发育不全(RR0.58,95CI0.38-0.88,I2=57%)和两个后交通动脉的发育不全或缺失(RR0.79,95CI0.71-0.87,I2=0%)在男性中更为普遍。
结论:CoW的一些解剖学变异是性别依赖性的,有些变体在女性中更常见,而另一些则在男性中更常见。未来的研究应该评估这些性别特异性CoW变异如何与颅内动脉瘤的性别特异性发生相关。