Magnetic Resonance Angiographic Study of the Anatomical Variations of the Anterior Communicating Artery Complex in a...

To provide a definition of arterial anomalies in the anterior communicating artery complex (ACoAC), determine their prevalence and investigate their relationship with aneurysms.

The three-dimensional time-of-flight magnetic resonance angiography images of 1,857 adult patients who presented to our hospital between January 2020 and September 2022 were evaluated retrospectively. The images of 1,537 cases were subsequently classified according to their ACoAC anatomical variants. The patients were further grouped as those with no pathology, those with ACoAC aneurysms and those with pathologies other than ACoAC, and the relationship between the ACoAC anatomical variants of each group was investigated using statistical methods. Rare variants such as trifurcations of the A2 segments, single A2 segments, fenestrations of the A1 segment and double AComAs were evaluated in separate groups.

The results of the classification of the 1,537 cases revealed the classical anatomical variant in 39.2% of the cases without ACoAC pathologies and 53.3% of the cases with ACoAC aneurysms. There was no significant difference between the sexes in terms of variant distribution (p=0.09), and no significant relationship between the presence of ACoAC aneurysms and sex (p=0.5).

ACoAC anatomical variants of the cerebral arterial system were detected in 60% of the cases. The most common anterior circulation (AC) vascular variants (VV) were A1 segment hypoplasia and aplasia. No clear relationship was found between intracranial aneurysms and anatomical variation.