| Objective:The rupture rate of ACoA aneurysms is higher than other cerebral aneurysms. The purpose of our study was to investigate the morphological characteristics predisposing to ACoA aneurysm rupture.Methods:A total of 114 anterior communicating artery aneurysms were retrospectively reviewed in a single institution from September 2013 to October 2014,88 of them were ruptured aneurysms and 26 of them were unruptured ones. Morphological characteristics were evaluated by CT angiography (CTA), including aneurysm shape, aneurysm diameter, width and its neck, aspect ratio,aneurysm angle, flow angle, dominance of the Al segment of the anterior cerebral artery, direction of the aneurysm dome, existence of other intracranial aneurysms, and some clinical characteristics.Result:Univariate analysis showed that aneurysm shape, aneurysm diameter (4.81mm vs 3.37mm), aneurysm width (4.93mm vs 3.33mm), aneurysm neck(3.52mm vs 2.81mm), aspect ratio (1.41mm vs 1.20mm), flow angle (139.18°vs 112.99°), dominance of the Al segment of the anterior cerebral artery, and existence of other intracranial aneurysms were significantly associated with ACoA aneurysms rupture. Multivariate logistic regression analysis showed that aneurysm neck (OR 2.950,95% CI 1.169-7.440, P=0.022), aspect ratio(OR 6.206,95% CI 1.305-29.520, P= 0.022), and flow angle (OR 1.121,95%CI 1.063-1.184, P= 0.000) were independent predictive factors for the rupture of ACoA aneurysms. And the ROC curve analysis for the flow angle showed that the threshold was 126.65°.Conclusion:Aneurysm neck, aspect ratio, flow angle were independent predictive factors for the rupture of ACoA aneurysms, and flow angle=126.65°may be the optimal threshold of rupture of the aneurysms. |
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