Department of Neurosurgery, First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China.
Department of Neurosurgery, First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China.
World Neurosurg. 2019 May;125:e807-e811. doi: 10.1016/j.wneu.2019.01.173. Epub 2019 Feb 7.
The purpose of this study was to investigate the imaging characteristics of fenestrated anterior communicating artery (AcomA) aneurysm and clinical outcome of patients with fenestrated AcomA aneurysm.
We performed a retrospective study of consecutive patients with AcomA aneurysms between January 2013 and December 2017. According to the vascular variations of the AcomA, the patients were divided into 2 groups: fenestrated AcomA aneurysms and non-fenestrated AcomA aneurysms. Baseline characteristics, clinical complications, and outcomes of patients were analyzed.
A total of 217 patients with AcomA aneurysms were included in this study. Compared to non-fenestrated AcomA aneurysms, the size of fenestrated AcomA aneurysms was significantly smaller (P < 0.001). Moreover, the patients with fenestrated AcomA aneurysms had a higher rate of rebleeding (P = 0.036), hydrocephalus (P = 0.017), delayed cerebral ischemia (P = 0.021), and pulmonary infection (P = 0.017) than those with non-fenestrated AcomA aneurysms. According to the Glasgow Outcome Scale (GOS) at follow-up, the patients with fenestrated AcomA aneurysms had a higher rate of disability (P = 0.035) (GOS 2-3) and mortality (P = 0.013) (GOS 1).
Fenestrated AcomA aneurysms are associated with higher clinical complications, and identification of AcomA fenestration contributes to successful clipping of AcomA aneurysms.
本研究旨在探讨前交通动脉（AcomA）动脉瘤开窗的影像学特征及开窗型 AcomA 动脉瘤患者的临床结局。
我们对 2013 年 1 月至 2017 年 12 月连续收治的 AcomA 动脉瘤患者进行了回顾性研究。根据 AcomA 的血管变异情况，将患者分为 2 组：开窗型 AcomA 动脉瘤和非开窗型 AcomA 动脉瘤。分析患者的基线特征、临床并发症和结局。
本研究共纳入 217 例 AcomA 动脉瘤患者。与非开窗型 AcomA 动脉瘤相比，开窗型 AcomA 动脉瘤的瘤体较小（P<0.001）。此外，开窗型 AcomA 动脉瘤患者再出血发生率（P=0.036）、脑积水发生率（P=0.017）、迟发性脑缺血发生率（P=0.021）和肺部感染发生率（P=0.017）均高于非开窗型 AcomA 动脉瘤患者。根据随访时的格拉斯哥结局量表（GOS）评分，开窗型 AcomA 动脉瘤患者残疾率（P=0.035）（GOS 2-3）和死亡率（P=0.013）（GOS 1）较高。
开窗型 AcomA 动脉瘤与较高的临床并发症相关，识别 AcomA 开窗有助于成功夹闭 AcomA 动脉瘤。
