Are Anterior Communicating Aneurysms Truly Anterior Communicating Aneurysms? An Observational Study

Copyright © 2019 Elsevier Inc. All rights reserved..

OBJECTIVE: The term anterior communicating (ACom) aneurysm is often broadly used to classify any aneurysm formed on the A1-A2 junction, A1, A2, or ACom arteries. Aneurysm location has been associated with rupture risk, so whether an aneurysm is truly formed on the ACom artery can critically affect treatment decisions. The aim of this study was to reclassify broadly termed ACom aneurysms into 4 subgroups (A1, A2, true ACom, and A1-A2 junction) based on their location.

METHODS: A retrospective, pilot study was conducted to identify all consecutive patients with ACom aneurysm managed over the past 4 years in a single center. Using computed tomography angiography, aneurysms were classified into 1 of the 4 subgroups. Additional information was collected on patient demographics, subarachnoid hemorrhages, projections of aneurysm dome, and aneurysm diameter.

RESULTS: A total of 48 aneurysms with available computed tomography angiography imaging were included in the final analysis. The reclassification of ACom aneurysms into subgroups resulted in 40 A1-A2 junction, 6 true ACom, 2 A2, and zero A1 aneurysms. A total of 100% versus 80% of true ACom and A1-A2 junction aneurysms ruptured, respectively. All elective coiling procedures were performed on unruptured A1-A2 junction aneurysms.

CONCLUSIONS: We found only 13% of the aneurysms initially referred to as ACom to be true ACom aneurysms. A more nuanced approach to ACom aneurysm classification may better guide management strategies.

Medienart:

E-Artikel

Erscheinungsjahr:

2019

Erschienen:

2019

Enthalten in:

Zur Gesamtaufnahme - volume:125

Enthalten in:

World neurosurgery - 125(2019) vom: 25. Mai, Seite e1089-e1092

Sprache:

Englisch

Beteiligte Personen:

Wong, Helen [VerfasserIn]
Banfield, Jillian [VerfasserIn]
Hughes, Nicole [VerfasserIn]
Shankar, Jai Jai Shiva [VerfasserIn]

Links:

Volltext

Themen:

Anterior communicating aneurysm
Journal Article
Observational Study
Subarachnoid hemorrhages

Anmerkungen:

Date Completed 03.01.2020

Date Revised 03.01.2020

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.wneu.2019.01.249

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM294157719