Asami Shiho, Uchino Akira, Usami Yoko, Nabeshima Taisuke, Baba Yasutaka
Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
Department of Radiology, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa, Sayama, Saitama, 350-1305, Japan.
Surg Radiol Anat. 2025 Apr 21;47(1):126. doi: 10.1007/s00276-025-03634-8.
To describe a case of true fenestration of an extremely long anterior communicating artery (ACoA).
A 3-year-old boy with a history of a ventricular septal defect and aortic coarctation underwent magnetic resonance imaging (MRI) and angiography (MRA) of the head and neck regions using a 3-Tesla scanner, for follow-up of stenosis at the origin of the innominate artery, which was a complication of aortic arch coarctation surgery.
MRA of the head region showed an extremely long ACoA of approximately 20 mm in length, with a fenestration of approximately 5 mm in size. No aneurysms were observed.
According to a meta-analysis, the mean length of the ACoA was 2.84 mm (0.38-10.4 mm). The ACoA has been reported to be the most frequent site of fenestration of intracranial arteries. However, most reported ACoA fenestrations are not true fenestrations, but duplications or partial duplications. We herein report a case of true fenestration of an extremely long ACoA, which is an extremely rare variant. To our knowledge, this is the first report of such an association in the relevant English language literature.
描述一例极长前交通动脉（ACoA）真性开窗的病例。
一名有室间隔缺损和主动脉缩窄病史的3岁男孩，因无名动脉起始处狭窄的随访，接受了使用3特斯拉扫描仪对头颈部区域进行的磁共振成像（MRI）和血管造影（MRA）检查，无名动脉狭窄是主动脉弓缩窄手术的并发症。
头部MRA显示一条极长的ACoA，长度约为20毫米，有一个大小约为5毫米的开窗。未观察到动脉瘤。
根据一项荟萃分析，ACoA的平均长度为2.84毫米（0.38 - 10.4毫米）。ACoA据报道是颅内动脉开窗最常见的部位。然而，大多数报道的ACoA开窗并非真性开窗，而是重复或部分重复。我们在此报告一例极长ACoA真性开窗的病例，这是一种极其罕见的变异。据我们所知，这是相关英文文献中首例此类关联的报道。
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