J Cerebrovasc Endovasc Neurosurg.  2023 Sep;25(3):267-274. 10.7461/jcen.2023.E2022.11.004.

Geometric influence of anterior cerebral artery rotation on the formation of anterior communicating artery aneurysm

• Heng S
• Lee SH
• Bae JW
• Choi YH
• Yoo DH
• Kim KM
• Cho WS
• Kang HS
• Kim JE

• KMID: 2546163
• DOI: http://doi.org/10.7461/jcen.2023.E2022.11.004

Abstract

Objective
Several particular morphological factors that contribute to the hemodynamics of the anterior communicating artery (ACoA) have been documented, but no study has investigated the role of the degree of anterior cerebral artery (ACA) rotation on the presence of ACoA aneurysms (ACoAAs).
Methods
A retrospective study of an institutional aneurysm database was performed; patients with ruptured or nonruptured ACoAAs were selected. Two sex- and age-matched control groups were identified: control Group A (nonaneurysms) and control Group B (middle cerebral artery aneurysms). Measurements of ACA rotation degree were obtained by using a three-dimensional imaging tool.
Results
From 2015 to 2020, 315 patients were identified: 105 in the ACoAA group, 105 in control Group A, and 105 in control Group B. The average age at the time of presentation was 64 years, and 52.4% were female. The ACA rotation degree of the ACoAA group was significantly higher than that of control Group A (p <0.01). The A1 ratio and the A1A2 ratio of the ACoAA group were greater than those of control Group A (p <0.01 and p <0.01, respectively). The ACA rotation degree correlated insignificantly with aneurysm size in ACoAA patients (p=0.78). The ACA rotation degree in the ACoAA group was also insignificantly different from that in control B (p=0.11).
Conclusions
The degree of ACA rotation was greater in the ACoAA group than in the nonaneurysm group, and it may serve as an imaging marker for ACoAA.

Keyword

Anterior cerebral artery; Rotation; Aneurysm; Anterior communicating artery

Figure

• 

  Fig. 1. The definition of parameter uses in the ACA rotation degree. The red line represents the ACoA line, where “a” is the starting point of right A2 and “b” is the starting point of left A2. These lines are connected and create the ACoA line. The blue line represents the ICA line created by both lateral parts of the petrous part of the ICA. The ACoA line that crosses the ICA line at a particular point. These two lines create a particular angle “yellow line”. ACA, anterior cerebral artery; ACoA, anterior communicating artery; ICA, internal carotid artery

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