Prevalence of ACA variations: A systematic review and meta‑analysis

Area of Science:

• Neurology
• Anatomy
• Radiology

Background:

• The anterior cerebral artery (ACA) exhibits critical anatomical variations.
• Distal ACA variations are classified into azygos, bihemispheric, and median types.
• Understanding ACA variations is crucial for clinical practice.

Purpose of the Study:

• To determine the precise incidence of distal ACA anatomical variations.
• To compare prevalence data between cadaveric and imaging studies.
• To consolidate existing research through a systematic review and meta-analysis.

Main Methods:

• Systematic review and meta-analysis of 48 articles.
• Utilized PICOS criteria and databases: Cochrane Library, PubMed, Embase, MEDLINE (until Dec 2023).
• Compared prevalence data from cadaveric (autopsy) and imaging studies.

Main Results:

• No statistically significant differences in prevalence were found between autopsy and imaging studies.
• Provided updated incidence data for azygos, bihemispheric, and median ACA variations.
• Identified a limited number of existing studies on ACA variation prevalence.

Conclusions:

• The meta-analysis offers accurate prevalence estimates for distal ACA variants.
• Autopsy and imaging methods yield comparable results for ACA variation prevalence.
• Highlights the need for further research due to limited existing studies.