Turkish Neurosurgery 2021 , Vol 31 , Num 2
Angiographic Morphology of Anterior Communicating Artery Aneurysms and Their Association with Rupture Risk
Veysel KAYA1,Mehmet KOLU2,Ahmet Turan KAYA3,Mehmet GEZER4,Kaya SARAC2,Bora TETIK5,Ismail Okan YILDIRIM2,Mehmet Akif DURAK5
1Kelkit State Hospital, Department of Radiology, Gumushane, Turkey
2Inonu University Hospital, Department of Radiology, Malatya, Turkey
3Amasya University, Department of Radiology, Amasya, Turkey
4University of Health Sciences, Mehmet Akif Inan Training Research Hospital, Department of Radiology, Sanliurfa, Turkey
5Inonu University Hospital, Department of Neurosurgery, Malatya, Turkey
DOI : 10.5137/1019-5149.JTN.30527-20.4 AIM: To estimate the rupture risk of anterior communicating artery (AComA) and AComA-related aneurysms according to their localization, angiographic architecture, and morphological features.

MATERIAL and METHODS: In this study, 124 patients with AComA and AComA-related anterior system aneurysms were retrospectively evaluated. The aneurysms were classified according to their morphological appearance and angiographic architecture. The size, size ratio, angiographic architecture, and aneurysmal dome orientation of ruptured and non-ruptured aneurysms were compared using digital subtraction angiography (DSA) 3D images.

RESULTS: There was a significant relationship between rupture risk and the size ratio (p=0.043), morphological properties of the aneurysm (p<0.001), aneurysm dome orientation (OR 1.29, 95% CI 1.32-6.818), and aneurysm type according to the angiographical architecture (p<0.005).

CONCLUSION: In determining the rupture risk of AComA and AComA-related aneurysms, size alone is not a sufficient parameter with aneurysm morphology proving to be more efficacious. Grouping of aneurysms according to angioarchitecture, and its significant correlation with aneurysm rupture, may help to understand the underlying mechanisms in the formation and rupture of aneurysms. From this, more specific treatment protocols can be created, helping to improve the clinical evaluation of AComA aneurysms. Keywords : Aneurysm, Anterior communicating artery, Angiographical architecture, Morphology, Dome orientation

Corresponding author : Veysel KAYA, drvkvkfk@gmail.com