Analysis of Anterior Cerebralarteriesin Patients with Ruptured Anterior Communicating Artery Aneurysmby Computed Tomography Angiography and Digital Subtraction Angiography

Bong, Ho Jin; Jang, Kyung Sool; Han, Young Min; Kim, Jong Tae; Chung, Dong Sup; Park, Young Sup

Abstract

OBJECTIVE
Computed tomography angiography (CTA) has recently been used for detecting cerebral aneurysm because of the accuracy of the images and the large supply of high-resolution CT scanners, and there is no need to perform cerebral digital subtraction angiography (DSA) when performing CTA. In contrast with DSA, CTA is unable to show the realtime cerebral blood flow. The aim of the present study is to find an appropriate aneurysm clipping method to reduce the risk during operation, and we did this by comparing the performance of CTA for detecting ruptured cerebral aneurysm with that of DSA.
METHODS
We performed a systemic review of patients suffering from ruptured anterior communicating artery aneurysm. We report here on the results obtained from November 2002 to March 2006. We reviewed a total of 37 patients who had undergone both CTA and DSA before surgery.
RESULTS
With performing CTA, 15 patients (40.5%) were observed to have the same thickness of both sides of the A1 (group A); there were 2 patients with right dominance (group B), and 20 patients with left dominance (group C). The total numbers of patients with an anomalous artery was 3 (12.5%). Two of them were in Group A and one of them was in Group B. Two of them (one in Group A and the other in Group B) were accessory A2 patients and the other was an azygous A2 patient. Also, there was no difference between CTA and DSA for the patients with an abnormal artery.
CONCLUSION
In the case of observing a severe hypoplastic A1 or an anomalous artery in the patients with anterior communicating artery aneurysm seen on the CTA, it is expected that checking the accurate structure and status of their aneurysm and the surrounding artery through performing DSA and also checking the contralateral carotid artery compression may help prepare the strategy for the operation and reduce the risk during operation.