Atherosclerotic changes of the parent artery associated with ruptures in small (<7 mm) anterior communicating artery aneurysms.

Authors

Nanhao Li, Xinjun Chen, Yutang Tan, Hao Chen, Yu Feng, Shen Yun Yuan, Wenyuan Zhao, Yihui Ma

Published in

Frontiers in neurology. Volume 17. Pages 1930043. Epub Sep 24, 2026.

Abstract

Small unruptured aneurysms are usually considered low-risk lesions and are typically managed conservatively. However, recent evidence indicates that small aneurysms account for a substantial proportion of ruptured intracranial aneurysms.
To determine which morphology- and hemodynamics-related parameters are associated with the rupture status of small (<7 mm) anterior communicating artery (ACoA) aneurysms.
We retrospectively reviewed 332 consecutive patients with ACoA aneurysms who were treated at our institute. Clinical data, imaging data, and intraoperative video recordings were reviewed and analyzed.
In total, 317 patients with small (<7 mm) ACoA aneurysms were included in the study, among whom 220 (69.4%) presented with ruptured aneurysms and 97 (30.6%) with unruptured aneurysms. The ruptured aneurysms showed a significantly higher height-to-width ratio, aspect ratio, and size ratio than the unruptured aneurysms (p < 0.05), and were more often irregular in shape or accompanied by a daughter sac. Among the 317 aneurysms, 53 aneurysms were analyzed for intracranial atherosclerosis and 47 aneurysms were evaluated to assess the hemodynamic parameters. Moderate-to-severe parent-artery atherosclerosis was also more significantly found in the ruptured aneurysms group (p < 0.01). Fluid-structure interaction analysis showed that, compared with the unruptured aneurysms, the ruptured aneurysms were associated with a lower time-averaged wall shear stress, higher oscillatory shear index, and higher von Mises stress in the parent artery.
Our study demonstrated that the rupture of small (<7 mm) ACoA aneurysms may be associated with the parent artery and aneurysmal neck atherosclerosis, the hemodynamic environment, and adverse morphological characteristics.

PMID:
42851394
Bibliographic data and abstract were imported from PubMed on 09 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.