Effects of Circle of Willis Anatomic Variations on Angiographic and Clinical Outcomes of Coiled Anterior Communicating Artery Aneurysms

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
Fig 1.
DSA studies showing examples of A1 segment categories with white and black arrows indicating right and left A1, respectively, for codominant (A) and dominant (B and C) configurations. Panels B and C demonstrate A1 dominant cases with diminutive and absent contralateral A1 segments, respectively.
Download figure
Open in new tab
Download powerpoint
Fig 2.
Anatomic dimensions of aneurysm neck width and remnants taken at baseline and follow-up imaging. All cases with available measurements in each group were included regardless of angiographic classification as listed in Table 1. The A1-dominant AcomA aneurysm group had a larger mean neck width at baseline and more variance in neck remnant at follow-up, P = .03 and .01 by *t test and **F test, respectively.

Table 1:

Angiographic classification data

Angiographic Occlusion	Baseline Post-Coiling			5–7 Month Follow-Up
Angiographic Occlusion	AcomA Aneurysm A1 Codominant (n = 33), No. (%)	AcomA Aneurysm A1 Dominant (n = 91), No. (%)	Basilar/MCA Termination Aneurysms (n = 89), No. (%)	AcomA Aneurysm A1 Codominant (n = 31), No. (%)	AcomA Aneurysm A1 Dominant (n = 86), No. (%)	Basilar/MCA Termination Aneurysms (n = 78), No. (%)
Complete	12 (36%)	48 (53%)	45 (50%)	13 (42%)	34 (40%)	22 (28%)
Neck remnant	16 (49%)	32 (35%)	29 (33%)	11 (35%)	31 (36%)	41 (53%)
Sac filling	5 (15%)	11 (12%)	15 (17%)	7 (23%)	21 (24%)	15 (19%)

Table 2:

CCT definition of success at 5–7 months

Angiographic Occlusion at First Follow-Up	AcomA Aneurysm A1 Co-Dominant (n = 31), No. (%)	AcomA Aneurysm A1 Dominant (n = 86), No. (%)
Complete	13 (42%)	29 (34%)
Stable	0 (0%)	3 (3%)
Improved	6 (19%)	17 (20%)
Total^{^a}	19 (61%)	49 (57%)

↵a There were 12 (39%) and 37 (43%) from each group that did not meet the CCT definition of success at 5–7 month follow-up.

Table 3:

Change in angiographic appearance from baseline to first follow-up