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To the Editor:
The article by Liebeskind et al.1 prompts the consideration of angiographic findings in cerebrovascular occlusive disease. Some aspects of the report are unclear.
The images presented for comparison were not obtained in the same circulation time. The first one shows better vertebral and carotid arteries proximal filling and in the second, middle and posterior cerebral arteries (MCA and PCA) are more evident. For this reason, there is no definite evidence of disease progression or collateral circulation pattern change. Circulation provided by area of Willis is a very important collateral pathway for lesions proximal to it, playing no role in those located distally.2
Lesions of the MCA can be divided into abrupt onset and slowly progressive. The difference …
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