Translational Research in Anatomy (Jun 2022)
A clinical investigation of the anatomy of the proximal anterior cerebral artery and its association with anterior communicating artery aneurysm
Abstract
Purpose: Aneurysms of the anterior communicating artery (ACoA) account for ∼22–25% of deaths attributed to subarachnoid haemorrhage secondary to ruptured aneurysms. The variant anatomy of the vessels surrounding the ACoA may alter hemodynamic forces which may have a bearing on the development of the ACoA aneurysm. The present study aimed to describe the anatomy of the proximal anterior cerebral artery and to describe ACoA aneurysm morphometry and projection. Methods: 100 CT angiograms of patients with ACoA aneurysm were analysed. Out of the 100 CT angiograms, aneurysm morphology was analysed on 75 CT reconstructed angiograms. The recorded parameters were statistically correlated with demographic characteristics. Results: The average length and diameter of the A1 segment of the anterior cerebral artery (ACA) was 13.36 ± 2.70 mm and 1.66 ± 0.47 mm on the right, respectively; and 12.43 ± 2.90 mm and 1.77 ± 0.53 mm on the left, respectively. The average length and diameter of the A2 segment of the ACA was 24.72 ± 6.12 mm and 1.59 ± 0.42 mm on the right, respectively; and 25.07 ± 5.88 mm and 1.60 ± 0.41 mm on the left, respectively. The aneurysm morphometry was described as mean dome length (5.80 ± 2.41 mm), mean dome diameter (4.43 ± 2.15 mm) and the mean neck diameter (3.02 ± 1.72 mm). The projection of the dome was classified as anterior (40%), posterior (6%), inferior (18%) and superior (36%). Conclusion: Variant anatomy of the vessels surrounding the ACoA were found in 53% of patients with ACoA aneurysm. Therefore, this study concurs with the literature that variant anatomy may be considered a risk factor for the development of ACoA aneurysms. Furthermore, knowledge of the anatomical parameters of the vessels surrounding the ACoA may be significant to the endovascular surgeon during pre-operative planning.
