Clinical and Morphological Factors for Ruptured Anterior Communicating Artery Aneurysms

Abstract

Introduction

The anterior communicating artery (ACoA) aneurysm, the most frequent cerebral aneurysm to rupture, carries a significant clinical burden, yet the factors influencing its rupture are limited in Indonesia. This study aims to determine the clinical and morphological features associated with ruptured ACoA compared to non-AcoA aneurysms among Indonesians.

Patients and Methods

We retrospectively reviewed our center’s aneurysm patient registry from January 2019 to December 2022, and compared the clinical and morphological features between ruptured ACoA aneurysms and ruptured aneurysms elsewhere with univariate and multivariate analyses.

Results

Of the 292 patients with 325 ruptured aneurysms, 89 were from ACoA. The mean age of patients was 54.99 years, with female preponderance in the non-ACoA group (non-ACoA: 73.31%, ACoA: 46.07%). On univariate analysis, ages ≥60 [ages 60–69: OR = 0.311 (0.111–0.869), p=0.026; ages ≥70: OR = 0.215 (0.056–0.819), p=0.024], female gender [OR = 0.311 (0.182–0.533), p<0.001], and smoking [OR=2.069 (1.036–4.057), p=0.022] exhibited significant association with ruptured ACoA aneurysm. On multivariate analysis, only the female gender was independently associated with ruptured ACoA aneurysm (aOR 0.355 [0.436–1.961], p=0.001).

Conclusion

In our study, ruptured ACoA aneurysm was inversely associated with advanced age, female gender, presence of daughter aneurysm, and directly associated with smoking. After multivariate adjustment, the female gender showed an independent association with ruptured ACoA aneurysm.

Keywords:

• ACoA aneurysm
• ruptured
• morphology
• risk factor
• Indonesian population

Data Sharing Statement

The data sets supporting the conclusions of this article are available upon reasonable request to the corresponding author.

Acknowledgments

The authors gratefully acknowledge National Brain Center Hospital Prof. Dr. dr. Mahar Mardjono for supporting this study.

Author Contributions

BR, BTP, RGK, AA, and MK contributed to the conception and design of the study. BR, BTP, and RGK collected the data utilized in the study. BR, KTG, and PRW conducted the data analysis and wrote the manuscript. All authors contributed to the manuscript revision, approved the final draft of the manuscript as well as the journal for publication, and agreed to be accountable for all aspects of the study.

Disclosure

The authors have no conflicts of interest to declare in this work.

Additional information

Funding

This study was funded and supported by Medtronic and Balt.