Journal article
Distribution of rupture sites and blebs on intracranial aneurysm walls suggests distinct rupture patterns in ACom and MCA aneurysms
International journal for numerical methods in biomedical engineering, v 40(8), e3837
Aug 2024
PMID: 38839043
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The mechanisms behind intracranial aneurysm formation and rupture are not fully understood, with factors such as location, patient demographics, and hemodynamics playing a role. Additionally, the significance of anatomical features like blebs in ruptures is debated. This highlights the necessity for comprehensive research that combines patient-specific risk factors with a detailed analysis of local hemodynamic characteristics at bleb and rupture sites. Our study analyzed 359 intracranial aneurysms from 268 patients, reconstructing patient-specific models for hemodynamic simulations based on 3D rotational angiographic images and intraoperative videos. We identified aneurysm subregions and delineated rupture sites, characterizing blebs and their regional overlap, employing statistical comparisons across demographics, and other risk factors. This work identifies patterns in aneurysm rupture sites, predominantly at the dome, with variations across patient demographics. Hypertensive and anterior communicating artery (ACom) aneurysms showed specific rupture patterns and bleb associations, indicating two pathways: high-flow in ACom with thin blebs at impingement sites and low-flow, oscillatory conditions in middle cerebral artery (MCA) aneurysms fostering thick blebs. Bleb characteristics varied with gender, age, and smoking, linking rupture risks to hemodynamic factors and patient profiles. These insights enhance understanding of the hemodynamic mechanisms leading to rupture events. This analysis elucidates the role of localized hemodynamics in intracranial aneurysm rupture, challenging the emphasis on location by revealing how flow variations influence stability and risk. We identify two pathways to wall failure-high-flow and low-flow conditions-highlighting the complexity of aneurysm behavior. Additionally, this research advances our knowledge of how inherent patient-specific characteristics impact these processes, which need further investigation.
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Details
- Title
- Distribution of rupture sites and blebs on intracranial aneurysm walls suggests distinct rupture patterns in ACom and MCA aneurysms
- Creators
- Yogesh Karnam - George Mason UniversityFernando Mut - George Mason UniversityAlexander K Yu - Allegheny General HospitalBoyle Cheng - Allegheny General HospitalSepideh Amin-Hanjani - Neurological SurgeryFady T Charbel - University of Illinois at ChicagoHenry H Woo - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellMika Niemelä - Helsinki University HospitalRiikka Tulamo - Helsinki University HospitalBehnam Rezai Jahromi - Helsinki University HospitalJuhana Frösen - Tampere UniversityYasutaka Tobe - University of PittsburghAnne M Robertson - University of PittsburghJuan R Cebral - George Mason University
- Publication Details
- International journal for numerical methods in biomedical engineering, v 40(8), e3837
- Publisher
- Wiley
- Grant note
- R01 NS121286 / NINDS NIH HHS 2R01NS097457 / NIH HHS R01NS121286 / NIH HHS R01 NS097457 / NINDS NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery; Neurosurgery
- Web of Science ID
- WOS:001239503000001
- Scopus ID
- 2-s2.0-85195261998
- Other Identifier
- 991021930317404721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Engineering, Biomedical
- Mathematical & Computational Biology
- Mathematics, Interdisciplinary Applications