Chrissicopoulos Christos, Mavrovounis Georgios, Piagkou Maria, Triantafyllou George, Nasis Nikolaos, Stranjalis George, Andreou Alexander, Kalamatianos Theodosis
Neurosurgery and Interventional Neuroradiology, Hygeia Hospital, Athens, GRC.
Neurosurgery, National and Kapodistrian University of Athens, Athens, GRC.
Cureus. 2024 Feb 24;16(2):e54800. doi: 10.7759/cureus.54800. eCollection 2024 Feb.
Objective The current retrospective angiographic study establishes the rates of variants in the distal anterior cerebral artery (DACA) in a sample of the Greek population. Methods Data were collected from 456 patients who underwent two-dimensional (2D) or three-dimensional (3D) digital subtraction angiography (DSA) of the carotid and vertebral arteries bilaterally. The study focused on patients with good visualization of the anterior and posterior circulations and employed magnetic resonance (MR) or computed tomography (CT) angiography for 3D reconstruction. The anterior cerebral artery (ACA) was classified into one of its two basic configurations, that is, with or without the callosomarginal artery (CMA). The bihemispheric, median, and azygos ACA patterns were also identified. Results The majority (373/456, 81.8%) exhibited a typical DACA pattern. The bihemispheric, median, and azygos patterns were identified in 66/456 (14.5%), 10/456 (2.2%), and 7/456 (1.5%), respectively. The CMA was present in 824/912 (90.4%) of the hemispheres, with a trend toward male predominance for bilateral presence (males: 167/192, 86.98%; females: 210/264, 79.55%; p = 0.05). In particular, the CMA was present significantly more frequently (p = 0.002) in the left hemispheres of male patients. Gender differences in CMA presence persisted in the analysis of the patients with a typical DACA pattern. Conclusion This study provides insights into the variations of the DACA in the Greek population. The observed gender differences in CMA rates suggest potential morphological variations in cerebral vasculature between males and females and contribute to a better understanding of vascular anatomy for clinical and surgical applications.
目的 本项回顾性血管造影研究确定了希腊人群样本中大脑前动脉远端（DACA）的变异率。方法 收集了456例双侧颈动脉和椎动脉接受二维（2D）或三维（3D）数字减影血管造影（DSA）的患者的数据。该研究聚焦于前后循环显示良好的患者，并采用磁共振（MR）或计算机断层扫描（CT）血管造影进行三维重建。大脑前动脉（ACA）被分为两种基本构型之一，即有或无胼周动脉（CMA）。还识别出了双侧半球型、中间型和单支型ACA模式。结果 大多数（373/456，81.8%）表现出典型的DACA模式。双侧半球型、中间型和单支型模式分别在66/456（14.5%）、10/456（2.2%）和7/456（1.5%）中被识别出。CMA在912个半球中的824个（90.4%）存在，双侧存在时有男性占优势的趋势（男性：167/192，86.98%；女性：210/264，79.55%；p = 0.05）。特别是，男性患者左半球中CMA的出现频率明显更高（p = 0.002）。在典型DACA模式患者的分析中，CMA存在的性别差异仍然存在。结论 本研究为希腊人群中DACA的变异提供了见解。观察到的CMA发生率的性别差异表明男性和女性脑血管系统可能存在形态学变异，并有助于更好地理解血管解剖结构，以用于临床和外科应用。
