Anatomical Variants of Anterior Cerebral Arterial Circle: A Study by Multidetector Computerized 3D Tomographic Angiography

Abstract

SUMMARY: One of the most common causes of stroke is rupture of aneurysms whose approach requires knowledge of anatomical variants. The aim of this study was to determine the prevalence of anatomical variants of the anterior cerebral artery (ACA) and the anterior communicating artery (AComA) by 3D computed tomography angiography (3D CTA) in Mexican individuals. A retrospective, observational, cross-sectional descriptive study of 283 patients, independent of sex or age, in which morphometric measurements of cerebral vessels were evaluated using contrasted 3D CTA from a period of two years was performed. We found at least one variant in a third of the study population (33.93 %). The most common variant was the absence of the AComA (14.1 %). A significant association between the hypoplastic variant of the right A1 segment and hypoplasia of the left A1 and the right A2 was found, while hypoplasia of the left A1 was associated with hypoplasia of the right A2. There is a difference in the prevalence of anatomical variants of the ACA-AComA complex in Mexican population in relation to other populations. The typical variant is the most prevalent form in the study population. However, the presence of atypical variants represents an important number that should be taken into account in clinical and surgical procedures. KEY WORDS: Anterior cerebral artery; Anatomical variant; Anterior communicating artery; Cerebral arterial circle; Subarachnoid hemorrhage; Cerebral endovascular surgery.