Romanian Neurosurgery (Dec 2023)
Angiographic and preoperative assessment
Abstract
Background: This study focuses on comparing and predicting the number of perforating arteries (PA) of the anterior communicating artery (AcoA) preoperatively by using cerebral angiographic studies and perioperative surgical observations. Materials and methods: From April 2010 - March 2012, 13 patients with subarachnoidal haemorrhages undergoing surgery to repair an AcoA aneurysm were evaluated with digital subtraction angiography (DSA) and perioperative surgical observations available for the study. Each patient’s number of PA arising from AcoA was investigated based on DSA imaging. DSA examinations were retrospectively evaluated by three neuroradiologists. The perioperative surgical observations were evaluated together by two neurosurgeons who performed surgical procedures. Results: The number of PA of AcoA was classified into four groups. Group 1: No PA; Group 2: PA 1 to 3; Group 3: PA 4 to 6; Group 4: PA> 6. In our study, in 6 of 13 patients (46.1%) three radiological evaluations were in accordance with each other; in 8 (61.5%) cases the number of PA found in surgical observation was higher than the number obtained from at least two radiologic examinations. In all radiological examinations, PA numbers were most commonly (%61.5) classified as Group 2 (PA numbers between 1-3); in 76.9% of cases, the number of PA found in surgical observation was equal or more than those of radiological evaluations. Additionally, in 5 (38.4%) cases, the number of PA found in surgical observation was higher than the number of those radiologic examinations. Conclusion: We found that the number of perforating arteries of AcoA segment obtained from the surgical observation is slightly higher than the number obtained from the preoperative DSA assessment.
