• Jianfeng Zheng, Zongduo Guo, Rui Xu, Zhaohui He, and Xiaochuan Sun.
• Department of Neurosurgery, First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China.
• World Neurosurg. 2019 May 1; 125: e807-e811.

ObjectiveThe 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.MethodsWe 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.ResultsA 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).ConclusionsFenestrated AcomA aneurysms are associated with higher clinical complications, and identification of AcomA fenestration contributes to successful clipping of AcomA aneurysms.Copyright © 2019 Elsevier Inc. All rights reserved.

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