scholarly journals Angiographic Study of the Anatomical Variations of the Anterior Communicating Artery Complex

2020 ◽  
pp. 97-101
Author(s):  
Mohamed Ali Eissa ◽  
Ahmed Ganna ◽  
Mohamed Amer ◽  
Ahmed Shakal
Keyword(s):  
Internal Carotid ◽  
Cerebral Arteries ◽  
Vascular Anatomy ◽  
Anatomical Variations ◽  
Vascular Pathology ◽  
Anterior Communicating Artery ◽  
Study Group ◽  
Digital Subtraction ◽  
Angiographic Study ◽  
Anatomical Variant

Introduction: The anterior communicating artery complex consists of two anterior cerebral arteries (ACA), the anterior communicating artery (AComA) and the recurrent arteries of Heubner. ACA is divided into the three segments; A1 originating from the internal carotid artery, A2 extending from AComA and A3 also known as the pericallosal artery. The anatomical variations of the ACoA complex are not adequately discussed. The aim of this study is to detect the anatomical variations in the ACoA complex in patients that don’t have any intracranial vascular pathology. Aims: The present study determines the anatomical Variations of the anterior communicating artery complex. Patients and Methods: The study group consists of 70 subjects, using Digital Subtraction Angiography and Computed Tomography Angiography to visualize the vascular anatomy. Results: About 14.29% (10 patients) Aplastic ACoA, 7.14% (5 patients) have unilateral A1 ACA segment hypoplasia, 2.86% (2 patients) have unilateral A1 ACA segment aplasia. Conclusion: The most common anatomical variant is Aplastic ACoA.

scholarly journals Cerebral Angiographic Study of Anatomical Variations of Anterior Cerebral Artery Complex in Bangladeshi Population

2016 ◽  
Vol 32 (2) ◽  
pp. 56-62
Author(s):  
Md Amir Hossain ◽  
Sharif Uddin Khan ◽  
Kazimohibur Rahman ◽  
Sirajeeshafiqul Islam ◽  
Khairulkabir Patwary ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Internal Carotid ◽  
Anterior Cerebral Artery ◽  
Cerebral Arteries ◽  
Anatomical Variations ◽  
Anterior Communicating Artery ◽  
Terminal Branch ◽  
Complex Anatomy ◽  
Proximal Anterior Cerebral Artery ◽  
Bangladeshi Population

Background: Anterior cerebral artery is an important terminal branch of internal carotid artery. It forms the anterior component of circle of Willis along with the anterior communicating artery. It is known for the frequent variations. The knowledge of anatomical variations in anterior cerebral artery is of considerable help to clinicians and interventionists. Method: Morphology and variations of the anterior cerebral arteries and the anterior communicating artery were studied in 90 patients undergone digital subtraction angiography (DSA). Results: Variations were found in 33% (n=30). Variations of the segments in relation with size, course, communications and terminations of the anterior cerebral artery (ACA) were noted. These were divided into different groups like hypoplasia, aplasia, duplication and fenestrations. Hypoplasia/Aplasia of proximal anterior cerebral artery (A1) was 24.5% in right side and 9% in left side. Anterior communicating artery (AComA) was found absent in 9% and fenestration in 9%. Callosomarginal artery was found absent in 2.2% in right side and 4.5% in left side. In right callosomarginal artery 6% had abnormal origin and 3.5% abnormal in left side.Pericallosal artery was present 100% on both sides. Conclusion: Variations of anterior cerebral artery complex anatomy is found common in Bangladeshi population. Bangladesh Journal of Neuroscience 2016; Vol. 32 (2): 56-62

Infundibular widening mimicking anterior communicating artery aneurysm

2013 ◽  
Vol 119 (1) ◽  
pp. 243-246 ◽  
Author(s):  
Jaechan Park ◽  
Dong-Hun Kang
Keyword(s):  
Internal Carotid ◽  
Correct Diagnosis ◽  
Artery Aneurysm ◽  
The Other ◽  
Anterior Communicating Artery ◽  
Digital Subtraction ◽  
Surgical Exploration ◽  
Perforating Artery ◽  
Anterior Choroidal ◽  
Choroidal Artery

Because infundibular widening most commonly appears at the origins of the posterior communicating artery and anterior choroidal artery from the internal carotid artery, its occurrence in association with the anterior communicating artery (ACoA) or the A1-A2 junction can be misinterpreted as an ACoA aneurysm on angiograms. The authors report on 2 such cases; one in a 73-year-old woman with infundibular widening of the recurrent artery of Heubner, and the other in a 44-year-old woman with infundibular widening of a perforating vessel from the ACoA. The correct diagnosis was established based on surgical exploration. In addition, grayscale modification of 3D reconstruction images of preoperative digital subtraction angiography revealed the cases of the recurrent artery of Heubner and perforating artery of the ACoA arising from the apex of the infundibular widening.

scholarly journals Anatomical variations of circle of Willis - a cadaveric study

2017 ◽  
Vol 4 (4) ◽  
pp. 1249 ◽  
Author(s):  
Ramanuj Singh ◽  
Ajay Babu Kannabathula ◽  
Himadri Sunam ◽  
Debajani Deka
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Anterior Part ◽  
Cerebral Arteries ◽  
Anatomical Variations ◽  
Circle Of Willis ◽  
Anterior Communicating Artery ◽  
Surgical Interventions ◽  
Collateral Channel ◽  
The Right

Background: The circle of Willis (CW) is a vascular network formed at the base of skull in the interpeduncular fossa. Its anterior part is formed by the anterior cerebral artery, from either side. Anterior communicating artery connects the right and left anterior cerebral arteries. Posteriorly, the basilar artery divides into right and left posterior cerebral arteries and each join to ipsilateral internal carotid artery through a posterior communicating artery. Anterior communicating artery and posterior communicating arteries are important component of circle of Willis, acts as collateral channel to stabilize blood flow. In the present study, anatomical variations in the circle of Willis were noted.Methods: 75 apparently normal formalin fixed brain specimens were collected from human cadavers. 55 Normal anatomical pattern and 20 variations of circle of Willis were studied. The Circles of Willis arteries were then colored, photographed, numbered and the abnormalities, if any, were noted.Results: Twenty variations were noted. The most common variation observed is in the anterior communicating artery followed by some other variations like the Posterior communicating arteries, Anterior cerebral artery and posterior cerebral artery (PCA) was found in 20 specimens.Conclusions: Knowledge on of variations in the formation of Circle of Willis, all surgical interventions should be preceded by angiography. Awareness of these anatomical variations is important in the neurovascular procedures.

scholarly journals Impact of Virtual Reality in Arterial Anatomy Detection and Surgical Planning in Patients with Unruptured Anterior Communicating Artery Aneurysms

2020 ◽  
Vol 10 (12) ◽  
pp. 963
Author(s):  
Samer Zawy Alsofy ◽  
Ioanna Sakellaropoulou ◽  
Makoto Nakamura ◽  
Christian Ewelt ◽  
Asem Salma ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Surgical Planning ◽  
Haptic Feedback ◽  
Three Dimensional ◽  
Vascular Anatomy ◽  
Anatomical Variations ◽  
Surgical Strategy ◽  
Anterior Communicating Artery ◽  
Head Positioning ◽  
Arterial Anatomy

Anterior-communicating artery (ACoA) aneurysms have diverse configurations and anatomical variations. The evaluation and operative treatment of these aneurysms necessitates a perfect surgical strategy based on review of three-dimensional (3D) angioarchitecture using several radiologic imaging methods. We analyzed the influence of 3D virtual reality (VR) reconstructions versus conventional computed tomography angiography (CTA) scans on the identification of vascular anatomy and on surgical planning in patients with unruptured ACoA aneurysms. Medical files were retrospectively analyzed regarding patient- and disease-related data. Preoperative CTA scans were retrospectively reconstructed to 3D-VR images and visualized via VR software to detect the characteristics of unruptured ACoA aneurysms. A questionnaire was used to evaluate the influence of VR on the identification of aneurysm morphology and relevant arterial anatomy and on surgical strategy. Twenty-six patients were included and 520 answer sheets were evaluated. The 3D-VR modality significantly influenced detection of the aneurysm-related vascular structure (p = 0.0001), the recommended head positioning (p = 0.005), and the surgical approach (p = 0.001) in the planning of microsurgical clipping. Thus, reconstruction of conventional preoperative CTA scans into 3D images and the spatial presentation in VR models enabled greater understanding of the anatomy and pathology, provided realistic haptic feedback for aneurysm surgery, and influenced operation planning and strategy.

scholarly journals Circle of Willis Collateral During Temporary Internal Carotid Artery Occlusion I: Observations From Digital Subtraction Angiography

2016 ◽  
Vol 43 (4) ◽  
pp. 533-537
Author(s):  
Stephen P. Lownie ◽  
Ramiro Larrazabal ◽  
Maximilian K. Kole
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Cross Flow ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Internal Carotid Artery Occlusion ◽  
Anterior Communicating Artery ◽  
Digital Subtraction ◽  
Anatomical Features

AbstractIntroduction: Impaired collateral circulation can lead to stroke during carotid endarterectomy. Carotid stump pressure (CSP) is used as a surrogate measure of collateral flow. The objective was to determine whether anatomical features obtained from digital subtraction angiography correlate with CSP during temporary internal carotid artery occlusion. The second objective was to use these features in combination to predict CSP. Methods: Digital subtraction angiographies from 102 patients obtained before endarterectomy were reviewed for anatomical variables including: degree of ipsilateral and contralateral carotid artery stenosis; patency of the anterior communicating artery; presence of cross-flow into ipsilateral middle cerebral artery branches; and size (< or ≥1 mm calibre) of the ipsilateral proximal anterior cerebral (A1), the contralateral A1, and the ipsilateral posterior communicating arteries. At surgery, systemic mean arterial pressure (MAP) and CSP were recorded. Multiple regression analysis was used to assess for anatomical features significantly associated with CSP. A “predicted CSP” equation was applied to 54 subsequent patients and correlated with measured CSP. Results: Variables correlating with CSP included MAP (p=0.001); the presence of severe contralateral carotid stenosis (p=0.002); patency of the anterior communicating artery (p=0.013); and the size of the contralateral A1 segment (p=0.029). Angiographic cross-flow, ipsilateral A1 size, and ipsilateral posterior communicating artery size were not significant. Predicted CSP correlated significantly with measured CSP (p<0.0001; R2=0.34). Conclusions: Anatomical features and systemic MAP are associated with carotid stump pressure during internal carotid artery occlusion and account for a significant amount of its variation.

scholarly journals Digital Subtraction Angiographic Study of Circle of Willis in Indian Population in a Tertiary Super-Specialty Hospital

2018 ◽  
Vol 3 (2) ◽  
pp. 99-105
Author(s):  
Muhammad Abdul Momen Khan ◽  
Shakir Husain ◽  
Md Shohidul Islam ◽  
Md Amir Hossain
Keyword(s):  
Digital Subtraction Angiography ◽  
Cerebrovascular Disorders ◽  
Clinical Importance ◽  
Uttar Pradesh ◽  
Anatomical Variations ◽  
Circle Of Willis ◽  
Anterior Communicating Artery ◽  
Digital Subtraction ◽  
Anterior Circulation ◽  
Cross Sectional

Background: Circle of Willis is an anastomotic polygon at the base of the brain which forms an important collateral network to maintain adequate cerebral perfusion. Changes in the normal morphology of the circle may causes the appearance and severity of symptoms of cerebrovascular disorders, such as aneurysms, infarctions and other vascular anomalies.Objectives: The aim of the present study was to analyses the anatomical variations of the circle of Willis by observing the variations in the cerebral arterial circle and was to clarify the clinical importance of these variations in certain forms of cerebrovascular diseases.Methodology: This cross-sectional study was conducted in the department of Neurointervention of Max Super-speciality Hospital, New Delhi, India and Neo multispeciality Hospital, Noida, Uttar Pradesh (UP), India during July 2016 to December 2016 for a period of six (6) months. Patients who were admitted in the Neurointervention department for digital subtraction angiography (DSA) were included in this study. The circle of Willis was then analyzed with the special reference to the complete or incomplete circle, any asymmetry in the configuration and variations in the size, and number of the component vessels, circle with multiple anomalies and absence, fenestration, duplication or triplication of any of the vessels.Results: Morphology and variations of the circle of Willis were studied in 74 patients undergone digital subtraction angiography (DSA). The normal pattern of circle of Willis was observed in 40(54.06%) cases and the remaining 34(45.94%) cases had one or more variations; however, 24(70.58%) cases had variations in the anterior circulation and 10(29.42%) cases had variations in the posterior circulation. 17(50%) cases had variations on the right side compared to 13(38.24%) variations on the left side. 4(11.76%) cases had variations in the anterior communicating artery. Incomplete circle of Willis were found 12(35.28%) cases. Multiple variations were observed in 11 cases (32.35%) in this study. In 4 cases anterior communicating artery aneurysms were observed.Conclusion: Variation of circle of Willis is common in this study of Indian population.Journal of National Institute of Neurosciences Bangladesh, 2017;3(2): 99-105

scholarly journals Effect of Age and Vascular Anatomy on Blood Flow in Major Cerebral Vessels

2014 ◽  
Vol 35 (2) ◽  
pp. 312-318 ◽  
Author(s):  
Sepideh Amin-Hanjani ◽  
Xinjian Du ◽  
Dilip K Pandey ◽  
Keith R Thulborn ◽  
Fady T Charbel
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Vascular Anatomy ◽  
Cerebral Vessels ◽  
Cerebral Vessel ◽  
Flow Rates ◽  
Adult Volunteers

Measurement of volume flow rates in major cerebral vessels can be used to evaluate the hemodynamic effects of cerebrovascular disease. However, both age and vascular anatomy can affect flow rates independent of disease. We prospectively evaluated 325 healthy adult volunteers using phase contrast quantitative magnetic resonance angiography to characterize these effects on cerebral vessel flow rates and establish clinically useful normative reference values. Flows were measured in the major intracranial and extracranial vessels. The cohort ranged from 18 to 84 years old, with 157 (48%) females. All individual vessel flows and total cerebral blood flow (TCBF) declined with age, at 2.6 mL/minute per year for TCBF. Basilar artery (BA) flow was significantly decreased in individuals with one or both fetal posterior cerebral arteries (PCAs). Internal carotid artery flows were significantly higher with a fetal PCA and decreased with a hypoplastic anterior cerebral artery. Indexing vessel flows to TCBF neutralized the age effect, but anatomic variations continued to impact indexed flow in the BA and internal carotid artery. Variability in normative flow ranges were reduced in distal vessels and by examining regional flows. Cerebral vessel flows are affected by age and cerebrovascular anatomy, which has important implications for interpretation of flows in the disease state.

Vascular angular remodeling by kissing-Y stenting in wide necked intracranial bifurcation aneurysms

2016 ◽  
Vol 9 (12) ◽  
pp. 1233-1237 ◽  
Author(s):  
Katharina Melber ◽  
Dan Meila ◽  
Philipp Draheim ◽  
Dominik Grieb ◽  
Björn Greling ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Internal Carotid ◽  
Posterior Inferior Cerebellar Artery ◽  
Anterior Communicating Artery ◽  
Digital Subtraction ◽  
Stent Deployment ◽  
Closed Cell ◽  
Cerebellar Artery ◽  
Before And After

IntroductionSingle stent deployment leads to a change in vascular geometry in wide necked bifurcation aneurysms. In some complex cases, the use of the single stent technique might not be sufficient or may not be feasible. The kissing-Y stenting technique appears to be an alternative endovascular treatment option. The aim of this study was to evaluate the effects of the kissing-Y stenting technique on vascular angular remodeling.Methods21 patients with wide necked intracranial bifurcation aneurysms at different sites (10 anterior communicating artery, 6 middle cerebral artery, 3 basilar artery, 1 vertebral artery/posterior inferior cerebellar artery, 1 internal carotid artery/posterior communicating artery) were treated with 44 closed cell stents (follow-up 2012–2016) using the kissing-Y stenting technique. We analyzed vascular angle geometry between the mother and both affected daughter vessels by digital subtraction angiography, before and after stent deployment, using standard working projections.ResultsEndovascular treatment of wide necked intracranial aneurysms using the kissing-Y stenting technique significantly decreased the angle between the bifurcation branches from 130.4±9.5° to 91.5±9.1° (p<0.0001).ConclusionsKissing-Y stenting in wide necked bifurcation aneurysms leads to vascular angular remodeling of both affected branches. The resulting straightening of the bifurcation angle may prevent aneurysmal recurrence.

scholarly journals Prediction of aneurysm location based on pattern of bleed on CT scan

2018 ◽  
Vol 21 (1) ◽  
pp. 21-28
Author(s):  
Binod Rajbhandari ◽  
Mohan Raj Sharma ◽  
Sushil Krishna Shilpakar ◽  
Gopal Sedain ◽  
Amit Pradhanang ◽  
...  
Keyword(s):  
Ct Scan ◽  
Vascular Pathology ◽  
Ruptured Aneurysm ◽  
Anterior Communicating Artery ◽  
Digital Subtraction ◽  
Imaging Studies ◽  
Ruptured Aneurysms ◽  
Valid Predictor ◽  
Cerebral Hematoma ◽  
Accuracy Of Prediction

Introduction: Computed tomography (CT) is the ‘gold standard’ for detecting subarachnoid hemorrhage (SAH) and digital subtraction angiography (DSA) for visualizing the vascular pathology. There is some correlation between the pattern (based on Fisher grading) and location of bleed on CT scan and eventual location of cerebral aneurysm(s). Our aim was to assess the correlation between distribution of hemorrhage on the initial CT scan and eventual site of the ruptured aneurysm at our institution. Methods: This retrospective review of prospectively collected data consisted of 50 patients with SAH over 8 months period. CT scan of patients performed within 72 hours after the ictus with suspected SAH were included in the study. Four neurosurgeons, who had at least three years of experience after being qualified, who were blind to the imaging studies, analyzed and scored independently the quantity and distribution of the hemorrhage on CT. Their prediction of the site of the ruptured aneurysm was recorded and this was correlated with the CT angiography (CTA) and/ or DSA findings. Results: Overall accuracy of prediction was 71.6 % (68.2-75%). Parenchymal cerebral hematoma was an excellent predictor for the site of a ruptured aneurysm but was present in only a few cases (16%). The next valid predictor was blood distribution on CT for ruptured anterior communicating artery (ACom) and middle cerebral artery (MCA) aneurysms (89.4% and 85% respectively). Pattern of blood on CT together with CTA/DSA findings was found to be reliable for identifying the ruptured aneurysm in patients with multiple aneurysms in all cases. Conclusion: The quantity and pattern of the blood on CT is a fairly reliable and quick tool for locating a ruptured MCA or ACom aneurysms. It is not, however, reliable for locating other ruptured aneurysms.  

scholarly journals Replaced right hepatic artery arising from the gastroduodenal artery: a rare and challenging anatomical variant of the Whipple procedure

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Eva María Pueyo-Périz ◽  
Patricia Sánchez-Velázquez ◽  
Maite De Miguel ◽  
Aleksandar Radosevic ◽  
Henrik Petrowsky ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Vascular Anatomy ◽  
Anatomical Variations ◽  
Arterial Injury ◽  
Whipple Procedure ◽  
Gastroduodenal Artery ◽  
Irreversible Damage ◽  
Anatomical Variant ◽  
Right Hepatic Artery ◽  
Replaced Right Hepatic Artery

Abstract Accurate assessment of the vascular anatomy is a prerequisite of any pancreatic resection, since an unnoticed arterial injury in the context of a complex resection such as Whipple procedure, can seriously jeopardize patient’s safety. This article aims to describe an infrequent anatomic variant of a replaced right hepatic artery originating directly from the gastroduodenal artery and its potential implications for duodenopancreatectomy, as the gastroduodenal artery is routinely divided. We present here two different cases of this arterial abnormality identified during a Whipple procedure and its implications in each different setting. Preoperative identification of anatomical variations is essential for proficient surgical planning. Nevertheless, when detected during surgery, an meticulous dissection of the hepatoduodenal ligament is required to identify all the vascular relations in order to avoid irreversible damage.

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