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Morphological risk factors for the rupture of anterior communicating artery aneurysms: the significance of fenestration

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

The purpose of this study was to evaluate morphological factors associated with rupture in anterior communicating artery (AcomA) aneurysms and to investigate the significance of AcomA fenestration as a risk factor for aneurysm rupture.

Methods

The clinical and radiologic findings of 255 patients with AcomA aneurysms treated with coil embolization between January 2005 and March 2014 were retrospectively reviewed. We performed univariate and multivariate analyses to evaluate the associations between morphological variables and rupture status.

Results

The number of patients with AcomA fenestration was 17 out of 255 (6.6 %). There were no statistically significant differences between the fenestration group and non-fenestration group in clinical and morphological characteristics. Multivariate logistic regression tests showed that superior direction of aneurysm dome (OR 2.802, p = 0.023), presence of a bleb (OR 5.998, p < 0.001), high aspect ratio (OR 3.138, p = 0.009), size greater than 7 mm (OR 3.356, p = 0.013), and AcomA fenestration (OR 4.135, p = 0.026) were significantly associated with AcomA aneurysm rupture.

Conclusions

The results of this study demonstrated that a fenestrated AcomA is associated with risk of aneurysm rupture. Therefore, AcomA fenestration can be considered as an important morphological risk factor for rupture, along with other known risk factors such as the direction of aneurysm dome, a bleb, high aspect ratio, and size.

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Abbreviations

AcomA:

anterior communicating artery

ICA:

internal carotid artery

ACA:

anterior cerebral artery

DSA:

digital subtract angiography

3DRA:

three-dimensional rotational angiography

SAH:

subarachnoid hemorrhage

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Acknowledgments

The authors would like to thank Jee TK for his help at various stages of this study.

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Authors and Affiliations

  1. Department of Neurosurgery, Bundang Jesaeng Hospital, Sungnam, Korea

    Jai Ho Choi

  2. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Keon Ha Kim & Pyoung Jeon

  3. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Kyung Il Jo, Je Young Yeon, Jong Soo Kim & Seung Chyul Hong

  4. Department of Interventional Neuroradiology, Samsung Medical Center, 50 Irwon-dong, Kangnam-gu, Seoul, Republic of Korea

    Keon Ha Kim

Authors
  1. Jai Ho Choi
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  2. Kyung Il Jo
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  3. Keon Ha Kim
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  4. Pyoung Jeon
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  5. Je Young Yeon
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  6. Jong Soo Kim
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  7. Seung Chyul Hong
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Corresponding author

Correspondence to Keon Ha Kim.

Ethics declarations

We declare that all human and animal studies have been approved by the Institutional Review Board of Samsung Medical Center (No. SMC 2015-02-105-001) and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to the inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

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Choi, J.H., Jo, K.I., Kim, K.H. et al. Morphological risk factors for the rupture of anterior communicating artery aneurysms: the significance of fenestration. Neuroradiology 58, 155–160 (2016). https://doi.org/10.1007/s00234-015-1610-9

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  • DOI: https://doi.org/10.1007/s00234-015-1610-9

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