Abstract WP86: Anterior Communicating Artery Cerebral Aneurysms, 10-year Treatment Experience at a Tertiary Referral Medical Center: Large Prevalence of Ruptured Small Aneurysms

Abstract

Purpose To determine patient characteristics and size distribution among ruptured and unruptured anterior communicating artery (AComA) aneurysms less than 7 mm treated with coiling or clipping in a 10-year time period at a tertiary referral medical center. A secondary objective is comparison of institutional data to published ISUIA data of 0% 5-year cumulative rupture risk for anterior circulation aneurysms < 7 mm. Materials & Methods We retrospectively reviewed AComA aneurysm characteristics in all patients who were treated with coiling or clipping from December 2002 until June 2012. Aneurysm location and maximum sac diameter were recorded utilizing catheter angiography or computed tomography angiography. Results In our series, 180 AComA aneurysms were treated from 12/2002 to 6/2012. 123 (68.0%) AComA aneurysms were treated in the setting of nontraumatic subarachnoid hemorrhage (SAH) while 57 (32.0%) were treated electively. Table 1 shows the characteristics of the AComA aneurysms in our series. Table 2 shows the size breakdown of ruptured and unruptured AComA aneurysms. Table 1. AComA Aneurysm Characteristics. Table 2. AComA Aneurysm Size Breakdown Conclusion Among ruptured AComA aneurysms, 61.0% had a maximum diameter < 7 mm, while 35.0% were < 5 mm, which argues against the reported low risk of rupture in aneurysms < 7 mm based on the ISUIA trial. Further studies are recommended to correlate risk of rupture with such factors as personal or family history of subarachnoid hemorrhage, medical comorbidities, and documented growth of aneurysm.