Microsurgical Treatment for Patients with Fenestrated Anterior Communicating Artery Aneurysms.

OBJECTIVE

The 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.

METHODS

We 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.

RESULTS

A 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).

CONCLUSIONS

Fenestrated AcomA aneurysms are associated with higher clinical complications, and identification of AcomA fenestration contributes to successful clipping of AcomA aneurysms.