| Background:Aneurysm rupture is associated with changes in the hemodynamics within the aneurysm,and the shape of the aneurysm can have a huge impact on the hemodynamics within the aneurysm.The anterior communicating artery（ACo A）is located below the optic chiasm.It is an important channel connecting the anterior cerebral arteries on both sides and is also an important part of the circle of Wills.Variation,here is the predilection site of aneurysm.Due to the complexity of the location of the ACo A,the morphological factors of the aneurysm at this location vary widely.A large number of studies have demonstrated the influence of morphological factors of anterior communicating artery aneurysm（Aco AA）on aneurysm rupture,but previous studies have reached different conclusions due to differences in the included study population.Therefore,in this study,the clinical data of patients with ACo AA in our center were used as samples,and whether the ACo AA ruptured on admission was used as the grouping standard,and the study patients were divided into a ruptured group and an unruptured group to further verify the rupture of ACo AA risk factors.Objective:Collect general clinical data and morphological factors of ACo AA patients.General clinical data included: gender,age,history of hypertension,history of diabetes,history of smoking,and history of drinking.The morphological factors of ACo AA include: aneurysm diameter,maximum height,aneurysm vertical height,aneurysm neck width,aspect ratio（AR value）,aneurysm orientation,A1-A2 angle,aneurysm angle（aneurysm angle,AA value）,blood flow angle（vessel angle,VA value）,whether the shape of the aneurysm is regular,whether it contains sub-tumors,the length of the A1 segment of the anterior cerebral artery,and whether the A1 segment of the anterior cerebral artery is absent on one side.According to whether the ACo AA ruptured and hemorrhaged at the time of admission,the research subjects were divided into two groups,the ruptured group and the unruptured group,respectively,and the data of the two groups were statistically analyzed.Methods:The clinical data of patients with ACo AA diagnosed by head CT angiography（CTA）in the Department of Neurovascular Diseases,First Hospital of Jilin University from January 2020 to July 2021 were collected.According to whether the ACo AA ruptured or not at the time of admission,the subjects were divided into ruptured group and unruptured group.SPSS software was used to analyze the general clinical data of patients and morphological factors of aneurysm.Results:1.The age of the patient,the history of diabetes,the diameter of the aneurysm,the vertical height of the aneurysm,the width of the aneurysm neck,the AR value,and the A1-A2 angle were statistically significant between the groups（P<0.05）.2.Multivariate Logistic regression analysis:age（OR0.862,95%CI: 0.789-0.942）,aneurysm diameter（OR48.180,95%CI: 9.947-233.352）,aneurysm neck width（OR0.013,95%CI: 0.002-0.074）,AR value（OR0.047,95%CI: 0.005-0.416）,A1-A2 angle（OR0.941,95%CI: 0.907-0.977）.3.ROC curve analysis showed that the AUC value of age was 0.380（95%CI: 0.026～0.279,P=0.026）,the AUC value of aneurysm diameter was 0.675（95%CI: 0.563～0.788,P=0.001）,and the The AUC value of neck width was 0.336（95%CI: 0.228～0.445,P=0.003）,the AUC value of AR value was 0.734（95%CI: 0.623～0.845,P=0.000）,the AUC value of A1-A2 angle was 0.351（95% CI: 0.242 to0.460,P = 0.006）.The best CUT-OFF value of AR value was 1.045,the sensitivity was 0.87,and the specificity was 0.63.The optimal CUT-OFF value of aneurysm diameter was 3.35,the sensitivity was 0.797,and the specificity was 0.583.Conclusion:1.Age,aneurysm diameter,aneurysm neck width,AR value,and A1-A2 angle are related to the rupture of the ACo AA.The younger the age,the narrower the aneurysm neck width,the smaller the A1-A2 angle,and the aneurysm diameter.The larger the AR value,the higher the rupture probability of the ACo AA.2.When the AR value is greater than 1.045 and the diameter of the aneurysm is greater than 3.35 mm,the ACo AA is easy to rupture. |
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