Wu Cai1, Chunhong Hu2, Jianping Gong3, Qing Lan4. 1. Department of Radiology, Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China; Department of Radiology, First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China. 2. Department of Radiology, First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China. Electronic address: sdhuchunhong@sina.com. 3. Department of Radiology, Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China. 4. Department of Neurosurgery, Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
Abstract
BACKGROUND: Recently, with improvements in computed tomography angiography and digital subtraction angiography, the assessment of certain morphologic traits of anterior communicating artery aneurysms (ACoAA) has drawn great attention. The determination of specific factors associated with rupture would provide much-needed guidance for the treatment of unruptured intracranial aneurysms, such as surgical clipping or endovascular coiling. Morphologic factors include, but are not limited to, aneurysm size, number, shape, dome direction, neck/dome ratio, and relationship of the aneurysm to the surrounding vessels. However, the results of previous investigations concerning morphologic parameters have yielded inconsistent results. METHODS: This review presents and analyzes the literature on the morphology of ACoAAs and risk of rupture. RESULTS: This literature review reveals that the strongest predictors of ACoAA rupture are size ratio, direction of the dome, and fenestration. These were the only factors that were either unanimously or near unanimously found to be predictive of rupture across multiple studies. CONCLUSIONS: The size ratio, direction of the dome, and fenestration should be examined most meticulously when deciding when to treat an ACoAA.
BACKGROUND: Recently, with improvements in computed tomography angiography and digital subtraction angiography, the assessment of certain morphologic traits of anterior communicating artery aneurysms (ACoAA) has drawn great attention. The determination of specific factors associated with rupture would provide much-needed guidance for the treatment of unruptured intracranial aneurysms, such as surgical clipping or endovascular coiling. Morphologic factors include, but are not limited to, aneurysm size, number, shape, dome direction, neck/dome ratio, and relationship of the aneurysm to the surrounding vessels. However, the results of previous investigations concerning morphologic parameters have yielded inconsistent results. METHODS: This review presents and analyzes the literature on the morphology of ACoAAs and risk of rupture. RESULTS: This literature review reveals that the strongest predictors of ACoAA rupture are size ratio, direction of the dome, and fenestration. These were the only factors that were either unanimously or near unanimously found to be predictive of rupture across multiple studies. CONCLUSIONS: The size ratio, direction of the dome, and fenestration should be examined most meticulously when deciding when to treat an ACoAA.
Authors: Jian Zhang; Pui Man Rosalind Lai; Anil Can; Srinivasan Mukundan; Victor M Castro; Dmitriy Dligach; Sean Finan; Vivian S Gainer; Nancy A Shadick; Guergana Savova; Shawn N Murphy; Tianxi Cai; Scott T Weiss; Rose Du Journal: Sci Rep Date: 2021-02-26 Impact factor: 4.379
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