• Wojciech Kaspera, Piotr Ładziński, Patrycja Larysz, Anna Hebda, Krzysztof Ptaszkiewicz, Marek Kopera, and Dawid Larysz.
• From the Department of Neurosurgery, Medical University of Silesia, Regional Hospital, Sosnowiec, Poland (W.K., P.Ł., P.L., M.K.); Radiodiagnostic Department (A.H.) and Department of Radiotherapy (D.L.), Maria Skłodowska-Curie Memorial Cancer Center, Institute of Oncology, Gliwice, Poland; and Radiodiagnostic Department, Specialist Hospital, Jaworzno, Poland (K.P.). wkaspera@wp.pl.
• Stroke. 2014 Oct 1; 45 (10): 2906-11.

Background And PurposeThe pathogenesis of cerebral aneurysms still raises some controversies. The aim of this study was to identify morphological, hemodynamic, and clinical independent risk factors for anterior communicating artery (ACoA) aneurysm development.MethodsComputed tomography angiography and transcranial color-coded sonography were performed in 77 patients with a nonbleeding ACoA aneurysm and in 73 controls. Symmetry of A1 segments of the anterior cerebral arteries, angles between A1 and A2 segments, tortuosity, diameter, mean velocity (Vm), pulsatility index, and volume flow rate in both A1 segments were determined. Moreover, all study participants completed a survey on their medical history. Multivariate backward stepwise logistic regression analysis was performed to identify independent risk factors for ACoA aneurysm development.ResultsSmoking, hypertension, asymmetry of A1 segments, the angle between A1 and A2 segments, A1 segment diameter, Vm, pulsatility index, and volume flow rate turned out to be associated with the occurrence of ACoA aneurysms on univariate analysis. Multivariate analysis identified smoking (odds ratio, 2.036; 95% confidence interval, 1.277-3.245), asymmetry of A1 segments>40% (odds ratio, 2.524; 95% confidence interval, 1.275-4.996), pulsatility index (odds ratio, 0.004; 95% confidence interval, 0.000-0.124), and the angle between A1 and A2 segments≤100° (odds ratio, 4.665; 95% confidence interval, 2.247-9.687) as independent strong risk factors for ACoA aneurysm development.ConclusionsThe risk of ACoA aneurysm formation is determined by several independent clinical, morphological, and hemodynamic factors. The strongest independent risk factors include smoking, asymmetry of A1 segments>40%, low blood flow pulsatility, and the angle between A1 and A2 segments≤100°.© 2014 American Heart Association, Inc.

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