Comparison between ruptured anterior choroidal artery aneurysms and ruptured intracranial aneurysms in other locations in relation to aneurysm dimensions at rupture

PurposeIt was noticed that anterior choroidal artery (AChoA) aneurysms appear to rupture at relatively smaller sizes compared with aneurysms in other intracranial locations, based on anecdotal clinical experience. We therefore aimed to compare ruptured AChoA aneurysms with other ruptured aneurysms in other intracranial locations, pertaining to aneurysm dimensions. This may help in finding out if the rupture risk stratification, based on the amalgamation of aneurysms of multiple locations in one group, precisely estimates aneurysm rupture risk.Methods255 ruptured intracranial aneurysms, which underwent assessment with catheter angiography with 3D reconstruction, in a single tertiary center between January 2000 and December 2023, were included. 6 aneurysm dimensions were compared.ResultsStatistically significant larger aneurysm maximum diameter, height, width and size ratio (SR) of the ruptured posterior communicating artery (PCOMM) aneurysms were identified when compared with ruptured AChoA aneurysms.No statistically significant difference in the aneurysm maximum diameter, height and width between the ruptured AChoA and ruptured anterior cerebral artery (ACA), anterior communicating artery (Acom), pericallosal artery and basilar tip aneurysms was found.AChoA aneurysms appear to rupture at a relatively small size, which is comparable to other aneurysm locations that are often grouped into different categories in rupture risk stratification.ResultsStatistically significant larger aneurysm maximum diameter, height, width and size ratio (SR) of the ruptured posterior communicating artery (PCOMM) aneurysms were identified when compared with ruptured AChoA aneurysms.No statistically significant difference in the aneurysm maximum diameter, height and width between the ruptured AChoA and ruptured anterior cerebral artery (ACA), anterior communicating artery (Acom), pericallosal artery and basilar tip aneurysms was found.AChoA aneurysms appear to rupture at a relatively small size, which is comparable to other aneurysm locations that are often grouped into different categories in rupture risk stratification.ResultsStatistically significant larger aneurysm maximum diameter, height, width and size ratio (SR) of the ruptured posterior communicating artery (PCOMM) aneurysms were identified when compared with ruptured AChoA aneurysms.No statistically significant difference in the aneurysm maximum diameter, height and width between the ruptured AChoA and ruptured anterior cerebral artery (ACA), anterior communicating artery (Acom), pericallosal artery and basilar tip aneurysms was found.AChoA aneurysms appear to rupture at a relatively small size, which is comparable to other aneurysm locations that are often grouped into different categories in rupture risk stratification.ConclusionMore detailed location-specific rupture risk estimation may be needed. The combination of multiple intracranial aneurysm locations into a single category for risk stratification may not reflect the true aneurysm size at rupture for some aneurysms.