Abstract
PurposeThe anatomy of the anterior communicating artery complex plays a critical role in surgical treatment of anterior cerebral circulation aneurysms. A thorough description of vascular variations of the anterior communicating artery complex seems to be lacking. The aim of this study was to describe the anatomical variations of the anterior communicating artery complex.MethodsThe study group consisted of 411 subjects (52.31 % women), without any intracranial pathologies, that had undergone head computed tomography angiography. We used maximum intensity projections, volume rendering and multi planar reconstructions to study and classify the anatomical variations of the anterior communicating and anterior cerebral arteries.ResultsMale subjects had a significantly higher prevalence of the typical anterior communicating artery complex (59.69 vs. 46.05 %; p < 0.01). The aplastic anterior communicating artery (23.26 vs. 15.88 %; p = 0.04) and triple A2 segment of the anterior cerebral artery (1.86 vs. 0.00 %; p = 0.05) were more common in women than in men.ConclusionFemale subjects have a higher incidence of variations in the anterior communicating artery complex. There is a higher incidence of anterior communicating artery aplasia among women.
Highlights
The anterior communicating artery complex consists of two anterior cerebral arteries (ACA), the anterior communicating artery (ACoA) and the recurrent arteries of Heubner [15, 16, 32]
ACA can be divided into the three following segments: A1 originating from the internal carotid artery, A2 extending from ACoA and A3 known as the pericallosal artery [11, 21]
The most common vascular variation was the aplastic ACoA (19.57 % of subjects) and it was more frequent in female subjects (23.15 % vs. 15.66 %; p = 0.04) (Fig. 3a)
Summary
The anterior communicating artery complex consists of two anterior cerebral arteries (ACA), the anterior communicating artery (ACoA) and the recurrent arteries of Heubner [15, 16, 32]. Little is known about the anatomical variations of the ACoA complex Many anomalies such as aplasia, hypoplasia, duplication or fenestration of ACA segments and ACoA have been described. Authors used various methods such as digital subtraction angiography, computed tomography angiography or intraoperative observations to study the anterior cerebral circulation. Those studies have a number of limitations. The authors base their conclusions on a relatively small study group, rarely exceeding 100 patients Their observations are often limited to the anomalies of the A1 segment (most commonly associated with ACoA aneurysms) regardless of ACoA and A2 segment anomalies [1]
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