1260. Vascular Alterations in Patients with Aneurysm: An Analysis of 361 Patients

Authors: Enrico Affonso Barletta; Telmo Belsuzarri; João Araújo; Maick Neves; José Aquino (São Paulo, Brazil)

Introduction: The vascular alterations are an important study subject once they can impair studies conclusions, change the treatment strategy or they can cause pathological alterations, such as aneurysms.

Methods:

Retrospective, observational analytic, transversal and longitudinal study, analyzing 454 vascular alterations and 361 patients that presented an aneurysm.

Results:
31 cases of Fetal-Type Posterior Cerebral Artery (FTPCA), 13 at left and 18 at right side. 8 FTPCA related to P1 and 5 to A1 hypoplasia, all hypoplasia was at the same side of the FTPCA. 6 ruptured aneurysms presented FTPCA, Hunt & Hess and Fischer average scores: 3 and 3,66; 83,3% of Fischer scores were 4.

3 Arteriovenous Malformation (AVM), nidus average: 4cm; feeding arteries: Anterior Cerebral Artery and Middle Cerebral Artery (MCA), MCA and Posterior Cerebral Artery (PCA), only PCA; Spetzler Martin score average: 2,6.

         2 Persistent Trigeminal Arteries (PTA), both related with saccular aneurysms.

            43 Internal Carotid Artery (ICA) stenosis. 4 presented 30 to 40% stenosis of ICA, 20 presented 50 to 60%, 11 presented 70 to 80% and 8 presented 90 to 99%.

            48 anterior circulation vasospasm and 11 posterior vasospasm. 63,6% of posterior vasospasm were moderate-severe.

Conclusion: FTPCA is related with A1 and P1 hypoplasia, this variations occurred always at the same side than FTPCA, so impairs brain's irrigation, stimulating aneurysms formation. FTPCA are related to more bulky hemorrhages at patients presenting ruptured aneurysms. The AVM related to aneurysms presented medium sizes and small Spetzler Martin score. PTA isn't related to the aneurysm pattern. Aneurysms are related with higher ICA stenosis (90,6% more than 50% stenosis). Posterior circulation vasospasm are more severe.