Predictive value of the anterior communicating artery (ACoA) complex variations for the incidence and rupture of ACoA aneurysms

Abstract

Abstract Background Increase pressure on arteries branching points and curves (hyperdynamic theory) is the most popular theory to explain the aneurysms formation that augmented by the observation of high incidence of anomalies (either A1 aplasia or hypoplasia) and the anterior communicating artery (ACoA) aneurysms. It still underestimated the correlation between these anatomical anomalies and aneurysm occurrence and its rupture. We aim to estimate the incidence and type of anatomical anomalies of the anterior cerebral circulation, including the A2 segment in patients with ACoA aneurysms and their predictive value for aneurysm occurrence and rupture parallel to the risk of hypertension. Also, we study the impact of these anomalies on the configuration of the aneurysm, including the neck and size. Results A1 hypoplasia and aplasia were significantly higher in AcoA aneurysms group than in the control group (P < 0.001 and 0.002, respectively). These anomalies have no significant statistical difference between rupture and unruptured ACoA aneurysms. A2 anomalies were insignificantly different between both groups. Conclusion Congenital anomalies in the A1 segment (hypoplasia and aplasia) have a significant predictive value for AcoA aneurysms formation, with no predictive value for the aneurysm rupture. Concomitantly, A2 anomalies have no significant risk for AcoA aneurysms formation and rupture.