Risk Factor Analysis of Vascular and Aneurysm Morphology for Ruptured Anterior Communicating Artery Aneurysm
Objective To investigate the risk factors of vascular and aneurysm morphological for rupture of anterior communicating artery aneurysm(ACoA).Methods A total of 211 patients with ACoA admitted to the Affiliated Hospital of Xuzhou Medical University from June 2016 to December 2022 were retrospectively collected,and they were divided into ruptured group(n=149)and unruptured group(n=62)according to whether they were ruptured or not.The general data of the patients were collected,the bifurcation angle of the anterior cerebral artery,the morphological parameters of the aneurysm,the diameters of the beginning segment of the dominant side middle cerebral artery(MCA)and the beginning segment of anterior cerebral artery A1 and the end of the internal carotid artery(ICA),the A1/ICA angle were measured.Multivariate Logistic regression analysis was used to analyze the risk factors of ACoA rupture,and Spearman rank correlation analysis was used to analyze the relationship between the diameters of the beginning segment of the dominant side MCA,the diameters of the beginning segment of anterior cerebral artery A1,the diameters of the end segment of ICA,the A1/ICA angle and ACoA rupture.Results Age,hypertension,aspect ratio(AR),aneurysm irregularity,variation of A1 segment,A2/anterior communicating artery(Acom)angle,and flow angle were risk factors affecting ACoA rupture.The A1/ICA angle was positively correlated with ACoA rupture,whereas the diameter of the beginning of the MCA was negatively correlated with ACoA rupture.Conclusion In addi-tion to age,hypertension,AR,and aneurysm irregularity as risk factors for aneurysm rupture,vascular morphology such as A1 segment variation,A2/Acom angle,and flow angle have a certain predictive effect on aneurysm rupture.In addition,when A1 segment mutates,the larger the A1/ICA angle on the dominant side,the smaller the diameter of the beginning segment of the MCA,and the easier the rup-ture of the ACoA.
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