Background

The aim of this study was to evaluate clinical and morphological factors associated with recurrence in anterior communicating artery (AcomA) aneurysms after clipping or coiling.

Methods

We retrospectively reviewed the clinical and radiologic features of consecutive 214 patients with AcomA aneurysms treated between January 2012 and December 2016 in a single tertiary institute. Univariate and multivariate analyses were performed to identify the relationship between clinical and morphological variables and recurrence.

Results

Of 214 patients, 166 were unruptured aneurysms and 109 were treated with coiling. Overall recurrence rate was 13% (28 out of 214 aneurysms) during mean 36.9 ± 18.4-month follow-up. Multivariate logistic regression analysis showed that size greater than 10 mm (OR = 5.651; 95% CI, 1.317–24.242; p = 0.020), smoking (OR = 3.474; 95% CI, 1.342–8.996; p = 0.010), coiling (OR = 2.98; 95% CI, 1.005–8.832; p = 0.049), and anterior direction of aneurysm (OR = 3.77; 95% CI, 1.12–12.66; p = 0.032) were significantly associated with recurrence of AcomA aneurysms after treatment.

Conclusions

The results of this study demonstrated that coiling, large aneurysm, anterior direction, and smoking history may be independent risk factors for the recurrence of AcomA aneurysms. Therefore, careful follow-up should be needed especially in large AcomA aneurysms with anterior direction after coiling.

中文翻译：

---

夹闭或盘绕后前交通动脉瘤复发的临床和形态危险因素。

背景

这项研究的目的是评估与钳夹或盘绕后前交通动脉（AcomA）动脉瘤复发相关的临床和形态因素。

方法

我们回顾性回顾了2012年1月至2016年12月在一家大专院校接受治疗的214例AcomA动脉瘤患者的临床和影像学特征。进行单变量和多变量分析以鉴定临床和形态学变量与复发之间的关系。

结果

在214例患者中，有166例未破裂的动脉瘤，其中109例进行了盘绕治疗。在平均36.9±18.4个月的随访中，总复发率为13％（214例中有28例）。多元logistic回归分析显示 吸烟大于10毫米（OR = 5.651; 95％CI，1.317–24.242; p = 0.020），吸烟（OR = 3.474; 95％CI，1.342–8.996; p  = 0.010），卷曲（ OR = 2.98； 95％CI，1.005-8.832；p  = 0.049），以及动脉瘤的前向（OR = 3.77； 95％CI，1.12-12.66；p  = 0.032）与治疗后AcomA动脉瘤的复发密切相关。

结论

这项研究的结果表明，盘绕，大动脉瘤，前向和吸烟史可能是AcomA动脉瘤复发的独立危险因素。因此，尤其是在大的AcomA动脉瘤在盘绕后朝前的情况下，应该进行仔细的随访。