Abstract
Background: The rupture risk of anterior communicating artery aneurysms (ACoAAs) has been known to be higher than that of aneurysms at other locations. Thus, the aim of this study is to investigate the clinical and morphological characteristics associated with risk factors for the rupture of ACoAAs.Methods: In total, 361 consecutive patients with 361 ACoAAs between August 2011 and December 2017 were retrospectively reviewed. Patients and ACoAAs were divided into ruptured and unruptured groups. In addition to clinical characteristics, ACoAA characteristics were evaluated by CT angiography (CTA). A multiple logistic regression analysis was used to identify the independent risk factors associated with ACoAA rupture. The assignment score of these variables depends on the β coefficient. A receiver operating characteristic (ROC) curve analysis was used to calculate the optimal thresholds.Results: The multiple logistic regression model revealed that A1 dominance [odds ratio (OR) 3.034], an irregular shape (OR 3.358), and an aspect ratio ≥1.19 (AR; OR 3.163) increased the risk of rupture, while cerebral atherosclerosis (OR 0.080), and mean diameters ≥2.48 mm (OR 0.474) were negatively correlated with ACoAA rupture. Incorporating these five factors, the ROC analysis revealed that the threshold value of the multifactors was one, the sensitivity was 88.3%, and the specificity was 66.0%.Conclusions: The scoring model is a simple method that is based on A1 dominance, irregular shape, aspect ratio, cerebral atherosclerosis, and mean diameters from CTA and is of great value in the prediction of the rupture risk of ACoAAs.
Highlights
Intracranial aneurysms (IAs) are common, and their ruptures are one of the main causes of subarachnoid hemorrhage (SAH)
Many previous studies showed that the locations of unruptured IAs (UIAs) were not associated with an increased rupture risk after a long period of follow-up [1, 2], the American Heart Association/American Stroke Association indicated that the treatment decision regarding UIAs is based mainly on the size and location [3]
The patients’ age, heart disease, cerebral atherosclerosis (CA), and SAH history were correlated with the risk of anterior communicating artery aneurysms (ACoAAs) rupture
Summary
Intracranial aneurysms (IAs) are common, and their ruptures are one of the main causes of subarachnoid hemorrhage (SAH). The treatment decisions related to incidental unruptured IAs (UIAs) still need careful consideration because most UIAs do not rupture during patients’ lifetimes, and prophylactic treatment is associated with risks. Many previous studies showed that the locations of UIAs were not associated with an increased rupture risk after a long period of follow-up [1, 2], the American Heart Association/American Stroke Association indicated that the treatment decision regarding UIAs is based mainly on the size and location [3]. Some studies showed that the risk factors of UIA ruptures differ by their location [5,6,7].
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