Advanced

AJNR - American Journal of Neuroradiology

Publication Preview: Published November 16, 2007

American Journal of Neuroradiology 2008;29:296.

This Article Full Text (PDF) All Versions of this Article: ajnr.A0807v1 29/2/296    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by de Gast, A.N. Articles by Sluzewski, M. Search for Related Content PubMed PubMed Citation Articles by de Gast, A.N. Articles by Sluzewski, M.

American Journal of Neuroradiology
DOI 10.3174/ajnr.A0807

INTERVENTIONAL

Fenestrations of the Anterior Communicating Artery: Incidence on 3D Angiography and Relationship to Aneurysms

A.N. de Gast, W.J. van Rooij and M. Sluzewski

From the Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands.

Please address correspondence to Willem Jan van Rooij MD, PhD, Department of Radiology, St. Elisabeth Ziekenhuis, Hilvarenbeekseweg 60, 5022 GC Tilburg, the Netherlands; e-mail: radiol{at}knmg.nl

BACKGROUND AND PURPOSE: Demonstration of fenestrations of the anterior communicating artery (AcomA) with conventional digital subtraction angiography is very uncommon. The purpose of this study was to assess the incidence of visible fenestrations of the AcomA on 3D rotational angiography (3DRA) and to evaluate the relationship between fenestrations of the AcomA and aneurysms of the AcomA.

MATERIALS AND METHODS: We systematically reviewed 305 datasets of 3DRA of the internal carotid artery in 305 patients with aneurysms of the anterior circulation on a dedicated workstation for the presence of fenestrations on the AcomA.

RESULTS: In 78 of 305 3DRAs, only the ipsilateral A2 segment was visible; thus, the AcomA could not be evaluated. Of the remaining 227 3DRAs, a fenestration of the AcomA was present in 12 (5.3%; 95% CI, 3.0%–9.1%). Of 12 fenestrations of the AcomA, 10 (83%) were associated with 1 or more aneurysms of the AcomA. Of 305 patients, 133 had an aneurysm on the AcomA, and in 127 of these, the AcomA was visible. Of 127 AcomA aneurysms with a visible AcomA, 10 were associated with fenestration, which accounted for an incidence of AcomA fenestrations with AcomA aneurysms of 7.9% (95% CI, 4.2%–14.0%). The proportion of fenestrations of the AcomA with aneurysms of the AcomA was 4.4% (10/227), and the proportion of AcomA fenestration with an aneurysm at another location was 0.9% (2/227). This difference was statistically significant (P = .040). Even in retrospect, 11 of 12 fenestrations were not visible on 2D DSA images.

CONCLUSION: In selected patients with aneurysms of the anterior circulation, fenestrations in the AcomA were found with 3DRA in 5.3% of datasets. Most fenestrations were associated with 1 or more aneurysms of the AcomA.

This article has been cited by other articles:

				W.J. van Rooij, M.E. Sprengers, A.N. de Gast, J.P.P. Peluso, and M. Sluzewski 3D Rotational Angiography: The New Gold Standard in the Detection of Additional Intracranial Aneurysms AJNR Am. J. Neuroradiol., May 1, 2008; 29(5): 976 - 979. [Abstract] [Full Text] [PDF]

				W.J. van Rooij, J.P.P. Peluso, M. Sluzewski, and G.N. Beute Additional Value of 3D Rotational Angiography in Angiographically Negative Aneurysmal Subarachnoid Hemorrhage: How Negative Is Negative? AJNR Am. J. Neuroradiol., May 1, 2008; 29(5): 962 - 966. [Abstract] [Full Text] [PDF]