Vascular Health and Risk Management (Jun 2023)

Clinical and Morphological Factors for Ruptured Anterior Communicating Artery Aneurysms

  • Rilianto B,
  • Prasetyo BT,
  • Kurniawan RG,
  • Gotama KT,
  • Windiani PR,
  • Arham A,
  • Kusdiansah M

Journal volume & issue
Vol. Volume 19
pp. 371 – 377

Abstract

Read online

Beny Rilianto,1,2,* Bambang Tri Prasetyo,1,2,* Ricky Gusanto Kurniawan,1,2,* Kelvin Theandro Gotama,1 Pratiwi Raissa Windiani,1 Abrar Arham,2,3 Muhammad Kusdiansah2,3 1Neurointervention Division, National Brain Center Hospital Prof. Dr. dr. Mahar Mardjono, East Jakarta, Indonesia; 2Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; 3Neurosurgery Department, National Brain Center Hospital Prof. Dr. dr. Mahar Mardjono, East Jakarta, Indonesia*These authors contributed equally to this workCorrespondence: Beny Rilianto, Neurointervention Division, National Brain Center Hospital Prof. Dr. dr. Mahar Mardjono, MT Haryono St No. Kav.11, Cawang, Kramat Jati, East Jakarta, Jakarta, 13630, Indonesia, Tel +62 21 29373377, Email [email protected]: The anterior communicating artery (ACoA) aneurysm, the most frequent cerebral aneurysm to rupture, carries a significant clinical burden, yet the factors influencing its rupture are limited in Indonesia. This study aims to determine the clinical and morphological features associated with ruptured ACoA compared to non-AcoA aneurysms among Indonesians.Patients and Methods: We retrospectively reviewed our center’s aneurysm patient registry from January 2019 to December 2022, and compared the clinical and morphological features between ruptured ACoA aneurysms and ruptured aneurysms elsewhere with univariate and multivariate analyses.Results: Of the 292 patients with 325 ruptured aneurysms, 89 were from ACoA. The mean age of patients was 54.99 years, with female preponderance in the non-ACoA group (non-ACoA: 73.31%, ACoA: 46.07%). On univariate analysis, ages ≥ 60 [ages 60– 69: OR = 0.311 (0.111– 0.869), p= 0.026; ages ≥ 70: OR = 0.215 (0.056– 0.819), p= 0.024], female gender [OR = 0.311 (0.182– 0.533), p< 0.001], and smoking [OR=2.069 (1.036– 4.057), p= 0.022] exhibited significant association with ruptured ACoA aneurysm. On multivariate analysis, only the female gender was independently associated with ruptured ACoA aneurysm (aOR 0.355 [0.436– 1.961], p=0.001).Conclusion: In our study, ruptured ACoA aneurysm was inversely associated with advanced age, female gender, presence of daughter aneurysm, and directly associated with smoking. After multivariate adjustment, the female gender showed an independent association with ruptured ACoA aneurysm.Keywords: ACoA aneurysm, ruptured, morphology, risk factor, Indonesian population

Keywords