Clinical features and rupture risk of anterior communicating artery aneurysms in different age groups

Abstract

Objective To determine clinical features and rupture risk of anterior communicating artery (AComA) aneurysms in different age groups. Methods The clinical data of 519 consecutive patients with AComA aneurysms in the First Affiliated Hospital of Wenzhou Medical University between December 2007 and February 2015 were reviewed and divided into younger group (< 65 years) and older group (≥ 65 years). The clinical characteristics and aneurysm morphologies were compared between the two groups. Results There were 390 aneurysms in younger group, and 129 in older groups. For the younger group, hypertension, the size of the aneurysms, maximum height, perpendicular height, size ratio (SR), aspect ratio (AR), aneurysm angle, A1 segment configuration, morphology showed significantly differences in ruptured aneurysms group compared with those in unruptured aneurysms (P <0.05). The multivariate analysis showed that significant difference between the two groups was aneurysm size (OR=1.461, 95% CI 1.027-2.079, P=0.035). For the older group, there were statistically significant differences in hypertension, size of the aneurysms, maximum height, perpendicular height, SR, aneurysm angle, vessel size and the distribution of aneurysm projection between the ruptured aneurysms group and unruptured aneurysms group (P < 0.05). The multivariate analysis showed that SR (OR=11.516, 95% CI 1.782-74.445, P=0.01) was the only significant predictor of aneurysm rupture. Between the younger and older groups, the distributions of sex, hypertension, smoke, vessel size and SR were statistically significant (P < 0.05). Conclusions For younger people, the males who smoked are more likely to have AcomA aneurysms and the size of the aneurysms is independent risk of aneurysm rupture. For older people, the females with hypertension also more often have AcomA aneurysms and the SR is independently associated with aneurysm rupture. Key words: Age; Anterior communicating artery; Intracranial aneurysm; Rupture; Risk factor