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Abstract Background and Purpose： The Anterior Communicating Artery (ACom) is one of the common sites of intracranial aneurysms (IA), and its rupture can severely affect the patient’s life and health. This study pays extensive attention to the morphological and hemodynamic characteristics of the anterior communicating artery aneurysm (ACoA) and further evaluates the causes of ACoA rupture by analyzing these factors. Methods： This study included patient data from January 2017 to October 2023 from the Chinese Multi-central Cerebral Aneurysm Database (CMAD), which contained imaging data for 119 cases. The relationship between clinical characteristics, morphological features, hemodynamic features, and the rupture of the ACoA was explored through traditional logistic regression models, personalized analysis of restrictive cubic spline regression (RCS) models for different factors, and correlation analysis. Results： In multivariable logistics regression (MLR), a history of ischemic stroke, smoking history, aneurysm neck width, and the angle between the anterior cerebral artery A1 segment and the anterior communicating artery (A1-ACom angle) are protective factors. In contrast, the diameter of the anterior communicating artery (ACom) and blood flow velocity are independent risk factors. Correlation analysis shows that there is a significant positive correlation between WFNs score and Hunt-Hess grading, and there is also a significant positive correlation between aneurysm height and aneurysm neck width, and aneurysm height and minimum wall shear stress (WSSmin). In the single-variable restricted cubic regression, the nonlinear model of aneurysm neck width shows some significance in the total threshold. There is significance between aneurysm neck width and a single covariate and all covariates. Conclusions： Factors such as aneurysm neck width, A1-ACom angle, the diameter of the ACom, and blood flow velocity affect the risk of rupture of the ACoA. The aneurysm neck width shows specific nonlinear characteristics in ACoA rupture.
Yang et al. (Wed,) studied this question.