A Comparative Study Of Anterior Cerebral Artery A1 Segment Aneurysms And Middle Cerebral Artery M1 Segment Aneurysms And Endovascular Treatment

Purpose:By collecting the relevant data of anterior cerebral artery A1 aneurysms and middle cerebral artery M1 aneurysms,the clinical characteristics of anterior cerebral artery A1 aneurysms and middle cerebral artery M1 aneurysms were compared.At the same time,the endovascular treatment and prognosis of anterior cerebral artery A1 segment aneurysm and middle cerebral artery M1 segment aneurysm were described and analyzed to provide relevant treatment strategies.Method:In this study,case data of patients diagnosed with anterior cerebral artery A1 segment aneurysms and middle cerebral artery M1 segment aneurysms by digital subtraction angiography(DSA)in the Department of Neurovascular Surgery,the First Hospital of Jilin University from August 2020 to October2022 were collected.A total of 40 cases of anterior cerebral artery A1aneurysms(42 cases in total)and 43 cases of middle cerebral artery M1aneurysms(44 cases in total)were collected.By retrospective analysis,the patients were divided into two groups according to the location of aneurysms.Gender,age,history of hypertension,history of SAH,treatment and prognosis of the patients were collected through the basic data and medical history of the patients.According to the DSA results of patients,aneurysm Size,morphology,Size Ratio,Aspect Ratio,Inflow Angle and anatomic characteristics of patients were collected.The PHASES Score was calculated and collected based on the patient’s age,presence or non-presence of hypertension,aneurysm size and location,and history of SAH.Finally,statistical analysis was conducted to explore the differences between anterior cerebral artery A1 segment aneurysms and middle cerebral artery M1 segment aneurysms.At the same time to provide certain strategies for its treatment.Results:According to statistical analysis,there was no statistical difference in age,gender,hypertension and other aspects between the anterior cerebral artery segment A1 aneurysm group and the middle cerebral artery segment M1 aneurysm group.The PHASES Score of the anterior cerebral artery aneurysm group was 5(4,5)in M(P25,P75).The PHASES Score of the middle cerebral artery M1 segment aneurysm group was 3(2,3)in M(P25,P75),and the difference was statistically significant(P< 0.001).At the same time,there was no statistical difference between anterior cerebral artery A1 segment aneurysm group and middle cerebral artery M1 segment aneurysm group in aneurysm Size,regular shape,Aspect Ratio,Size Ratio and Inflow Angle.According to the description analysis,the number of the 42 anterior cerebral artery A1 aneurysms distributed in the anterior,middle and posterior segments of A1 was31(73.8%),4(9.5%)and 7(17.7%),respectively.The number of projection directions were 1(2.4%),3(7.1%),4(9.5%)and 34(81.0%),respectively.Among the 44 M1-segment aneurysms of middle cerebral artery,8(18.2%),26(59.1%)and 10(22.7%)were distributed in the anterior,middle and posterior segments of M1,and 27(61.4%)and 17(38.6%)were projected in the upper and lower segments,respectively.Secondly,in terms of endovascular therapy,among the 28 patients with A1 segment aneurysms of the anterior cerebral artery who completed endovascular therapy,only 2 patients had related complications,and the remaining 26 patients were successfully treated and had a good prognosis,with a cure rate of up to 92.9%.Among 38 patients with M1-segment aneurysms of the middle cerebral artery who completed endovascular therapy,only 2 patients had related complications,and the remaining 36 patients were successfully treated and had a good prognosis,with a cure rate of 94.7%.Conclusion:(1)Anterior cerebral artery segment A1 aneurysms may be more likely to rupture and bleed than middle cerebral artery segment M1 aneurysms,with higher risk.(2)Aneurysms in segment A1 of the anterior cerebral artery are mainly distributed in segment A1 of the anterior cerebral artery and protrude posteriorly,which may be related to the release of the returning artery.The M1-segment aneurysms of the middle cerebral artery were mainly distributed in the middle part of M1 and protruded upward,which may be related to the release of the leptoplast artery.(3)Endovascular treatment of anterior cerebral artery A1 segment aneurysms and middle cerebral artery M1 segment aneurysms is safe and effective.