Abstract
ObjectivesWe decided to perform computer-aided analysis of the anterior cerebral artery (ACA) to check for a potential correlation with anterior communicating artery (ACoA) aneurysm presence and growth.MethodsWe retrospectively analyzed the ACA anatomy of 121 patients with ACoA aneurysms along with 121 age, risk factors, and vessel side-matched control patients without an ACoA aneurysm. We obtained their medical history and digital subtraction angiography (DSA) data from their medical records. For each patient’s DSA, we extracted curve representing the course of their ACA and calculated its relative length (RL), sum of angle metrics (SOAM), triangular index (TI), product of angle distance (PAD), and inflection count metrics (ICM).ResultsPatients with ACoA aneurysm had significantly higher RL (0.64 ± 0.23 vs. 0.56 ± 0.22; p < 0.01), SOAM (0.27 ± 0.19 vs. 0.18 ± 0.15; p < 0.01), PAD (0.12 ± 0.13 vs. 0.09 ± 0.11; p = 0.02), and TI (0.57 ± 0.14 vs. 0.44 ± 0.15; p < 0.01). In multivariate logistic regression analysis, after adjustment for possible confounders, SOAM (OR, 1.34; 95% CI, 1.12–1.63; p < 0.01) and TI (OR, 1.84; 95% CI, 1.47–2.35; p < 0.01) remained independently associated with higher risk of ACoA aneurysm. Additionally, we found significant negative correlations between TI and aneurysm dome size (R = − 0.194; p = 0.047).ConclusionsIncreased tortuosity of ACA might increase the risk of ACoA aneurysm development and decrease the risk of aneurysm growth.Key Points• Anterior cerebral artery’s sum of angle metrics is associated with hypertension as well as with history of ischemic stroke and myocardial infarction.• Increased tortuosity of anterior cerebral artery might be associated with anterior communicating artery aneurysm development.• Tortuosity of anterior cerebral artery is negatively correlated with anterior communicating artery aneurysm dome size.
Highlights
Vessel tortuosity has been found in a number of organ systems [1], is associated with several systemic diseases, such as hypertension and diabetes mellitus [2, 3], and may be indicative of vascular pathologies [4, 5] and increases with age [6]
The control group consisted of 121 patients without an intracranial aneurysm or with aneurysm located on different arteries than anterior communicating artery (ACoA), anterior cerebral artery (ACA), or internal carotid artery (ICA)
We found no significant difference in terms of inflection count metrics (ICM) between patients with and without ACoA aneurysm (0.10 ± 0.14 vs. 0.08 ± 0.09; p = 0.11) (Table 2)
Summary
Vessel tortuosity has been found in a number of organ systems [1], is associated with several systemic diseases, such as hypertension and diabetes mellitus [2, 3], and may be indicative of vascular pathologies [4, 5] and increases with age [6]. Cerebral vessel tortuosity has been previously documented to coexist with hypertension and moyamoya disease [8, 9]. To the best of our knowledge, tortuosity of only two cerebral arteries— internal carotid artery and vertebral artery—has far been shown to be associated with higher risk of intracerebral aneurysm development [13, 14]. No association between anterior cerebral artery (ACA) tortuosity and anterior communicating artery (ACoA) aneurysm development has far been reported
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