Risk factors for anterior communicating artery aneurysm rupture

Abstract

Background: Although the research on the risk factors of anterior communicating artery (AComA) aneurysm has made great progress, the independent effect of each risk factor on the rupture of AComA aneurysm is controversial among different studies. We will perform a protocol for systematic review and meta-analysis to investigate risk factors for AComA aneurysm rupture and quantify their independent effects. Methods: A systematic search according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines in PubMed, Embase, and the Cochrane Library databases was conducted from inception to August 31, 2021 for published studies concerning risk factors for AComA aneurysm rupture. In the absence of statistical heterogeneity (ie, P > .10 and I 2 < 50%), we will use a fixed-effects model to pool the results across sufficient studies. Otherwise, we will present the results employing the random-effects model. Quality assessment of the included studies will be evaluated using the Newcastle–Ottawa Scale. Statistical analyses will be performed using Stata16 (Stata Corporation, College Station, TX, USA) software. Results: The findings of this study will be submitted to peer-reviewed journals for publication. Conclusion: This systematic review will provide evidence to determine the risk factors that affect the rupture of the AComA aneurysm and quantify their independent effects. Ethics and dissemination: Since the proposed study uses pre-published data, ethical approval is not required. Review registration number: CRD42021284262. ( https://www.crd.york.ac.uk/PROSPERO/ ).

Circulation remodeling after flow diversion of an anterior communicating artery aneurysm: A case report

“…Endovascular embolization offers another approach, and there is a growing toolset available to aid in the treatment of complicated aneurysms. Indeed, the outcomes after endovascular embolization, such as the use of a FRED, have a similar success rate to open surgery [ 1 , 5 , 6 , 10 , 12 ]. Flow diverters have increasingly become a treatment of choice due to high cure rates and low rates of complications [ 3 ].…”

“…Furthermore, aneurysms in this location account for the most common cause of aneurysmal subarachnoid hemorrhage and have the most complex anatomy of the anterior circulation [ 1 , 5 ]. Indeed, they have a higher risk for rupture than any other aneurysm within the anterior cerebral circulation according to a recent meta-analysis [ 10 ].…”

“…The high risk of rupture of ACOM aneurysms, regardless of size, suggests the apparent need for intervention. The incidence of ACOM aneurysms has increased in recent years likely due to the improvement of minimally invasive imaging techniques [ 10 ].…”

Clinical and Morphological Factors for Ruptured Anterior Communicating Artery Aneurysms

“… 5 , 6 ACoA aneurysms are also the most frequent to rupture, accounting for up to 40% of aSAH. 7 , 8 Being adjacent to a number of important blood vessels and structures, the complex management of ACoA aneurysms – ie, surgical clipping, endovascular coiling – carries notable potential iatrogenic complications and financial burden. 5 , 7 Accordingly, an understanding of factors that contribute to the rupture of ACoA aneurysms is of considerable value to physicians in treatment decision-making.…”

“… 2 , 5 , 8–12 However, in addition to displaying geographical variation, a consensus on which of these variables are consistent descriptors of rupture risk is nonexistent and, inevitably, the applicability of scoring systems in guiding treatment plans remains questionable. 8 , 12–15 …”