Rupture Risk Factors and Strategies for Unruptured Distal Anterior Cerebral Artery Aneurysms

• Published in: World neurosurgery 2024-02, Vol.182, p.e785-e791
• Main Authors: Takeda, Naoya, Kurihara, Eiji, Kuroda, Ryuichi, Inoue, Satoshi, Lee, Te-Jin, Nakahara, Masahiro, Nakamura, Naoto, Sasayama, Takashi
• Format: Article
• Language: English
• Subjects: Aspect ratio; Distal anterior cerebral artery aneurysm; Endovascular treatment; Rupture risk; Size ratio
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2023.12.039

Distal anterior cerebral artery (dACA) aneurysms are rare. Ruptured dACA aneurysms typically present with subarachnoid hemorrhage in conjunction with intracerebral hematoma and cause neurological deterioration. This study aimed to determine their risk of rupture and examine associated factors. We retrospectively analyzed patients with dACA aneurysms to compare patient and aneurysm characteristics between ruptured and unruptured aneurysms. Clinical outcome was used the modified Rankin scale. Univariate analyses were performed to identify rupture risk factors. One hundred three patients with dACA aneurysms were examined (51 ruptured and 52 unruptured). The median aspect ratio of ruptured and unruptured aneurysms was 1.69 and 1.22, respectively (P 2.4 had ruptured. Distal anterior cerebral artery (dACA) aneurysms may rupture, even when small. We found a significant difference between ruptured and unruptured aneurysms with respect to maximum diameter, aspect ratio, and size ratio. Treatment for small aneurysms should be considered based on size ratio and aspect ratio, not just size.