Angles between A1 and A2 Segments of the Anterior Cerebral Artery Visualized by Three-dimensional Computed Tomographic Angiography and Association of Anterior Communicating Artery Aneurysms

Abstract

ACoA aneurysms are associated with the smaller A1-A2 angle junction of the ACoA complex, where higher hemodynamic stress may occur in patients with normoplastic A1 segments.

Volume versus standard coils in the treatment of intracranial aneurysms

“…ACOM aneurysms often exhibit complex parent vessel relationships and are frequently associated with anomalies of the ACOM. They are associated with a smaller A1–A2 angle junction and hypoplastic or aplastic A1 segments 32. Considering the tortuosity and length, it is more complicated to control and safely place coils and possible assistance devices.…”

Hemodynamic Patterns of Anterior Communicating Artery Aneurysms: A Possible Association with Rupture

“…Observations in patients with AcoA aneurysms have lent support to this hypothesis. Aneurysms of the AcoA complex are more likely to have asymmetric A1 segments (5); and furthermore, to have exclusively filling angiographically from one A1 segment in up to 78% cases (6). Experimentally, AcoA aneurysms can be produced in hypertensive rats by unilaterally ligation of the common carotid artery (7) further supporting a causative relationship between increased flow and aneurysm formation.…”

Evaluation of the perforators of the anterior communicating artery (AComA) using routine cerebral 3D rotational angiography

“…Recent advances in 3DRA provide a sensitive technique to characterize aneurysm geometry and to obtain information about the surgical anatomy around the AComA complex and aneurysms before surgery 17. Using an operating microscope, the origin and relation of the perforators to the aneurysm neck can also be visualized, but the visualization of them prior to surgery using high-quality 3D angiography has not yet been implemented routinely in the clinic.…”

“…With recent advances in three-dimensional rotational angiography (3DRA), the ability to determine the anatomy around the AComA and the aneurysm of a patient before surgery or endovascular treatment17 has improved. We therefore retrospectively analyzed 3DRA reconstructions of a consecutive series of 20 patients with aneurysms of the AComA, focusing on the perforating arteries around the aneurysms.…”