Can vessel diameters, diameter ratios, and vessel angles predict the development of anterior communicating artery aneurysms: A morphological analysis

Abstract

The anterior communicating artery (AcomA) junction is the most common location for cerebral aneurysms. This might because of increased vascular wall stress due to the complex structure of the junction. The aim of this study investigate the effect of morphological parameters in the development of AcomA aneurysms. This retrospective study was approved by the institutional ethics committee. A retrospective analysis of our hospital database was performed to identify patients with AcomA aneurysms. Patients with normal computed tomography angiography (CTA) examinations were enrolled in the study as the control group. The control group was similar to the patient group in gender and age. Morphological parameters (vessel diameters, vessel diameter ratios, and vessel angles) on the same side (ipsilateral) and on the opposite side (contralateral) of the patients with aneurysm, and morphological parameters of the control group were compared. A total of 171 subjects were involved in the study (86 patients with aneurysms and 85 patients in the control group). Multivariate regression analysis revealed that the ipsilateral A1 -A2 angle (OR: 0.932; 95% CI: 0.903-0.961; p < 0.001), the ipsilateral A1/A2 vessel diameter ratio (OR: 27.725; 95% CI: 1.715-448.139; p = 0.019), and the contralateral internal carotid artery (ICA)/A1 ratio (OR: 11.817; 95% CI: 2.617-53.355; p = 0.001) were significant morphological predictors for developing an aneurysm. An increased contralateral ICA/A1 ratio, an increased ipsilateral A1 /A2 vessel diameter ratio, and a narrow bifurcation angle are significant predictors for developing an aneurysm. Therefore, in patients with clinical risk factors these parameters may be interpreted as additional morphological risk factors for developing an aneurysm. (C) 2019 Elsevier Ltd. All rights reserved.