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KMID : 0364519930050010089
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Dong-A Journal Medicine
1993 Volume.5 No. 1 p.89 ~ p.96
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Analysis of Anterior Communicating Artery Aneurysm According to Hemodynamic Factor and Anatomical Variation
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Abstract
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Most of the arteries that harbor aneurysms are tortuous, and the change in the direction of flow associated with the curves creates a hemodynamic stress on the wall of the anterior cerebral artery near the junction of the anterior communicating
artery.
Saccular aneurysm points in the direction that the blood would flow if the arterial curve is not present.
Author analyzed 51 cases of the ruptured anterior communicating artery aneurysm which were classified into three types according to the hemodynamic factor and anatomical variation around the anterior communicating artery on the 4-vessel cerebral
angiogram.
@ES The results are as follows:
@EN 1. The aneurysm usually arose at the point where the dominant horizontal segment of ACA (A1) bifurcated at the level of the anterior communicating artery in 40 cases(78%).
2. These aneurysms usually pointed away from the dominant A1 segment toward the opposite side in 24 cases of Type A(75%) and to other directions in 8 cases(25%).
3. The direction in which the fundus points is determined by the course of the anterior cerebral arteries which are proximal to their junction with the anterior communicating artery.
Three types were classified according to the hemodynamic factor and anatomical variations around the anterior communicating artery. Type A of 32 cases(63%). Type b of 8 cases(16%) and Type C of 11 cases(21%).
Therefore, the hemodynamic factor & anatomical variation around the anterior communicating artery play an important role in the formation, growth and rupture of aneurysm. Furthermore its preoperative recognition is also important to determine the
optimal operation site(right or left) and the degree of frontal lobe retraction, and thereby, prevent the premature rupture and postoperative complication.
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