Angiographic outcome after endovascular therapy for anterior communicating artery aneurysms: correlation with vascular morphological features.

PURPOSE: The purpose of this study is to analyze the effect of morphological features on angiography after endovascular embolization for anterior communicating artery (AcoA) aneurysms. MATERIALS AND METHODS: We conducted a retrospective case review of 32 consecutive patients (19 males and 13 females) with AcoA aneurysms treated by endovascular coil embolization between February 2003 and August 2011. Mean age was 61 years (range 36-90 years). Twenty-eight aneurysms were ruptured and 4 were unruptured. We evaluated morphological features included direction of the dome, dome size, dome to neck ratio, presence of irregularity, and angle between A1 segment of the anterior cerebral artery and C1 segment of the internal carotid artery. Immediate angiographic results (complete or incomplete occlusion) and the occurrence of procedural complications (aneurysmal rupture and thromboembolic events) were correlated with morphological features. Fisher's exact test was used for statistical analysis. RESULTS: A single factor significantly associated with incomplete occlusion was superior dome direction (p = 0.037). Other morphological features did not correlate with angiographical results. There was no correlation between morphological features and procedural complications. CONCLUSION: Incomplete occlusion after coil embolization for AcoA aneurysms is more common in cases of superior dome direction.