Original scientific paper

https://doi.org/10.20471/acc.2022.61.02.15

Clinical Characteristics and Morphological Parameters Associated with Rupture of Anterior Communicating Artery Aneurysms

Filip Vitošević ; Neuroradiology Department, Center for Radiology and MRI, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Svetlana Milošević Medenica ; Neuroradiology Department, Center for Radiology and MRI, University Clinical Center of Serbia, Belgrade, Serbia
Vladimir Kalousek ; Department of Radiology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Stefan Mandić-Rajčević ; Institute of Social Medicine and School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Mina Vitošević ; Faculty of Medicine, University of Pristina, Kosovska Mitrovica, Serbia
Milan Lepić ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department of Neurosurgery, Military Medical Academy, Belgrade, Serbia
Krešimir Rotim ; Department of Neurosurgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia
Lukas Rasulić ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department of Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia

Abstract

We analyzed aneurysm morphology, demographic and clinical characteristics in patients
with anterior communicating artery (ACoA) aneurysms to investigate the risk factors contributing
to aneurysm rupture. A total of 219 patients with ACoA aneurysms were admitted to our hospital between
January 2016 and December 2020, and morphological and clinical characteristics were analyzed
retrospectively in 153 patients (112 ruptured and 41 unruptured). Medical records were reviewed to
obtain demographic and clinical data on age, gender, presence of hemorrhage, history of hypertension,
diabetes, heart disease, and kidney disease. Morphological parameters examined on 3-dimensional digital
subtraction angiography included aneurysm size, neck diameter, aspect ratio, size ratio, bottleneck
ratio, height/width ratio, aneurysm angle, (in)flow angle, branching angle, number of aneurysms per
patient, shape of the aneurysm, aneurysm wall morphology, variation of the A1 segment, and direction
of the aneurysm. Male gender, aspect ratio, height/width ratio, non-spherical and irregular shape were
associated with higher odds of rupture, whilst controlled hypertension was associated with lower odds
of rupture, when tested using univariate logistic regression model. In multivariate model, controlled hypertension,
presence of multiple aneurysms, and larger neck diameter reduced the odds of rupture, while
irregular wall morphology increased the risk of rupture. Regulated hypertension represented a significant
protective factor from ACoA aneurysm rupture. We found that ACoA aneurysms in male patients and
those with greater aspect ratios and height/width ratios, larger aneurysm angles, presence of daughter
sacs and irregular and non-spherical shapes were at a higher risk of rupture.

Keywords

Anterior communicating artery; Intracranial aneurysm; Aneurysm rupture; Aneurysm morphology; Clinical risk factors; Subarachnoid hemorrhage

Hrčak ID:

284789

URI

https://hrcak.srce.hr/284789

Publication date:

1.8.2022.

Article data in other languages: croatian

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