Jian Zhang1, Anil Can2, Pui Man Rosalind Lai3, Srinivasan Mukundan4, Victor M Castro5, Dmitriy Dligach6, Sean Finan7, Vivian S Gainer5, Nancy A Shadick8, Guergana Savova7, Shawn N Murphy9, Tianxi Cai10, Scott T Weiss11, Rose Du12. 1. Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Jiangsu, China. 2. Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands. 3. Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. 4. Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. 5. Research Information Systems and Computing, Mass General Brigham, Boston, Massachusetts, USA. 6. Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA; Department of Computer Science, Loyola University, Chicago, Illinois, USA. 7. Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA. 8. Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. 9. Research Information Systems and Computing, Mass General Brigham, Boston, Massachusetts, USA; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA. 10. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. 11. Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. 12. Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: rdu@bwh.harvard.edu.
Abstract
OBJECTIVE: To identify clinical and morphologic risk factors correlated with anterior communicating artery (ACoA) aneurysm formation. METHODS: Three-dimensional morphologic parameters obtained from computed tomography angiography or digital subtraction angiography from 504 patients with ACoA aneurysms and 201 patients with aneurysms in other locations that were diagnosed at Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016 were evaluated. The presence of hypoplastic and aplastic A1 segments and diameters and angles of surrounding parent and daughter vessels were examined. Univariable and multivariable statistical analyses were performed to determine statistical significance. Sensitivity analyses for small (≤3 mm) aneurysms only were also performed. RESULTS: Aplastic and hypoplastic A1 segments were more common in the ACoA group (38.9% vs. 6.5% hypoplastic and 22.2% vs. 0.5% aplastic). In multivariable analysis, the presence of a hypoplastic A1 segment was associated with ACoA aneurysms. An A2-ACoA (daughter-daughter) angle was also significantly associated with ACoA aneurysms in multivariable analysis; however, as Pearson's correlation test between aneurysm width and daughter-daughter angle was significant, the daughter-daughter angle was most likely not independently associated with aneurysm presence, but rather might have been a result of the presence of an aneurysm. Subgroup analyses of small aneurysms (≤3 mm) and of unruptured aneurysms showed similar results. CONCLUSIONS: Our results demonstrate that of all the morphologic parameters, the presence of a hypoplastic A1 segment was the only parameter independently associated with the presence of ACoA aneurysms that was not correlated with aneurysm size and could aid as a simple screening parameter.
OBJECTIVE: To identify clinical and morphologic risk factors correlated with anterior communicating artery (ACoA) aneurysm formation. METHODS: Three-dimensional morphologic parameters obtained from computed tomography angiography or digital subtraction angiography from 504 patients with ACoA aneurysms and 201 patients with aneurysms in other locations that were diagnosed at Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016 were evaluated. The presence of hypoplastic and aplastic A1 segments and diameters and angles of surrounding parent and daughter vessels were examined. Univariable and multivariable statistical analyses were performed to determine statistical significance. Sensitivity analyses for small (≤3 mm) aneurysms only were also performed. RESULTS: Aplastic and hypoplastic A1 segments were more common in the ACoA group (38.9% vs. 6.5% hypoplastic and 22.2% vs. 0.5% aplastic). In multivariable analysis, the presence of a hypoplastic A1 segment was associated with ACoA aneurysms. An A2-ACoA (daughter-daughter) angle was also significantly associated with ACoA aneurysms in multivariable analysis; however, as Pearson's correlation test between aneurysm width and daughter-daughter angle was significant, the daughter-daughter angle was most likely not independently associated with aneurysm presence, but rather might have been a result of the presence of an aneurysm. Subgroup analyses of small aneurysms (≤3 mm) and of unruptured aneurysms showed similar results. CONCLUSIONS: Our results demonstrate that of all the morphologic parameters, the presence of a hypoplastic A1 segment was the only parameter independently associated with the presence of ACoA aneurysms that was not correlated with aneurysm size and could aid as a simple screening parameter.
Authors: Anna Zurada; Jerzy Gielecki; R Shane Tubbs; Marios Loukas; Wojciech Maksymowicz; Michał Chlebiej; Aaron A Cohen-Gadol; Jarosław Zawiliński; Dariusz Nowak; Maciej Michalak Journal: Surg Radiol Anat Date: 2011-02-17 Impact factor: 1.246
Authors: M J Krabbe-Hartkamp; J van der Grond; F E de Leeuw; J C de Groot; A Algra; B Hillen; M M Breteler; W P Mali Journal: Radiology Date: 1998-04 Impact factor: 11.105
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