Prevalence of ACA variations: A systematic review and meta‑analysis

The anterior cerebral artery (ACA) and its divisions enclose symptomatically critical and supplementary differentiations. Anatomical variations of the distal ACA that are irregularly detected can be separated into three major groups, namely, azygos, bihemispheric and median ACA variations. The present study performed a systematic review and meta-analysis. The PICOS criteria and electronic databases, namely the Cochrane Library, PubMed (until December, 2023), Embase (until December, 2023) and MEDLINE (until December, 2023) were used to identify 48 articles to fulfill the eligible criteria. As a limited number of studies exist on the prevalence of ACA anatomical variations, the present meta-analysis aimed to determine the precise incidence of these variants. In addition, with the comparative description between cadaveric (autopsy) and imaging cases, more accurate results were extract from the prevalence presentation of the distal ACA variants. On the whole, no statistically significant differences were found between autopsy and imaging studies.