Abstract：Objective: The anterior communicating artery(Acom) aneurysm is considered the most complex in all cerebral aneurysms, and the relationship between the Acom morphology parameters and the Acom aneurysm formation is not clear. In this study, we aimed to determine the relationship of bifurcation angle, anterior cerebral artery(ACA) and Acom diameters associated with Acom aneurysm. Methods: The digital substraction angiography(DSA) of 698 patients was used in this study, including 171 patients with Acom aneurysm and 527 control subjects. The Acom/A2 angle, artery diameter and Acom aneurysm geometric characteristics were examined. Results: With aging, the apex angle of ACA-Acom bifurcation(Acom/A2) angle, was significantly increased(P＜0.000 1). Conversely, the Acom/A1 and A1/A2 angles were significant decreased(P=0.000 2 and P＜0.000 1, respectively). The Acom/A2 angle was significantly wider in patients with Acom aneurysm than in the controls(P＜0.000 1), whereas A1/A2 and Acom/A1 angles in the aneurysm group were significantly smaller than in the control group(P＜0.000 1 and P=0.003 7, respectively). Furthermore, a statistical positive correlation between the Acom, A1/A2 segment of ACA diameter and aneurysm geometric size(P＜0.000 1), and aneurysm neck was observed(P＜0.000 1). Conclusion: Acom aneurysms are associated with the wider Acom/A2 angle junction of the Acom complex, and bifurcation artery diameter shows a significant positive correction with aneurysm size.
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