Association between A1 segment dysplasia, bifurcation angles of anterior cerebral artery and the formation of anterior communicating aneurysms

doi:10.3969/j.issn.1006-7795.2022.01.012

Abstract

Abstract: Objective To investigate the relationship between the dysplasia and bifurcation angles of A1 segment of the anterior cerebral artery (ACA) and the formation of the anterior communicating aneurysms (ACoA). Methods Totally 272 patients with anterior communicating artery (Acom) bifurcation aneurysms who underwent CT angiography (CTA) and digital subtraction angiography (DSA) or clipping surgery (aneurysm group) and 272 age and sex matched subjects (control group) were retrospectively collected in Jinling Hospital, Nanjing, China between Jan. 2010 and Mar. 2017. A1 segment of ACA was assessed by an experienced radiologist in the aneurysm group and normal group as symmetric, hypoplasia, and absence, as well as ACA bifurcation angles. The angles between the A1 or A2 segment and Acom (A1/Acom, A2/Acom) and between the A1 and A2 segments (A1/A2) were measured. Results The mean age of all patients was (54±11) years and 55.15% subjects were female. In the aneurysm group, 70.96% of aneurysms were in the left Acom bifurcation, and 29.04% in the right. The median size was 4.54 (3.64, 6.01) mm. 229 cases (84.19%) had A1 segment hypoplasia or absence in aneurysm group, of which 223 cases (81.99%) were contralateral, 6 cases (2.21%) were ipsilateral. In the control group, 126 cases (46.32%) had A1 segment hypoplasia or absence. A1 segment hypoplasia or absence in the aneurysm group (84.19%) was higher than that in the control group (46.32%) (P<0.001). The A2/Acom angle [125.01 (108.89,144.55)°] in the aneurysm group was higher than that in the control group [101.44 (91.30,115.17)°], and the A1/A2 angle (110.01±20.72)° was lower than that in the control group (130.28±18.30)° (P<0.001), and the A1/Acom angle [107.86 (93.47,128.18)°] was lower than that in the control group [111.99 (100.18,126.66)°](P=0.05). Conclusions The presence of ACoA is associated with hyposplasia or absence of A1 segment (especially contralateral), larger A2/Acom and smaller A1/A2 and A1/Acom angles of the ACA bifurcation,and A1 segment hypoplasia or absence and the A2/Acom bifurcation angle were independent risk factors for AcoA formation.

Key words: computed tomography angiography, A1 segment dysplasia, bifurcation angle, anterior communicating aneurysm

CLC Number:

R445

Wang Li, Shi Zhao, Kong Xiang, Yang Liu, Liu Ya, Luo Song, Zhang Longjiang. Association between A1 segment dysplasia, bifurcation angles of anterior cerebral artery and the formation of anterior communicating aneurysms[J]. Journal of Capital Medical University, 2022, 43(1): 61-66.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2022.01.012

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2022/V43/I1/61

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