Elevated Lipid Infiltration Is Associated With Cerebral Aneurysm Rupture

Area of Science:

• Cerebrovascular disease
• Biomedical engineering
• Cardiovascular research

Background:

• Intracranial aneurysm wall degradation is linked to lipid infiltration.
• Quantitative analysis of lipid infiltration's role in aneurysm rupture is lacking.
• Low-density lipoprotein (LDL) transport is a key factor in aneurysm wall pathology.

Purpose of the Study:

• To quantitatively investigate the correlation between lipid infiltration and cerebral aneurysm rupture.
• To simulate and analyze LDL transport within patient-specific aneurysm models.
• To identify key parameters associated with aneurysm rupture risk.

Main Methods:

• Analysis of 62 aneurysms, incorporating patient blood pressure, plasma LDL concentration, and 3D angiographic data.
• Patient-specific simulation of LDL transport to quantify lipid infiltration.
• Comparison of morphological, hemodynamic, and lipid accumulation parameters between ruptured and unruptured aneurysm groups.
• Multivariate logistic regression to identify independent predictors of rupture.

Main Results:

• Univariate analysis identified size ratio, wall shear stress, low shear area, relative residence time, and LDL infiltration rates as significant.
• Multivariate analysis confirmed average LDL infiltration rate as the sole significant independent predictor of rupture (P < 0.05).
• A predictive model based on LDL infiltration demonstrated strong performance for rupture prediction (AUC = 0.885).

Conclusions:

• Ruptured intracranial aneurysms exhibit significantly higher levels of LDL infiltration compared to unruptured ones.
• Lipid infiltration, particularly LDL accumulation, is implicated as a promoting factor in aneurysm rupture.
• Incorporating lipid infiltration characteristics into risk assessment models can improve the prediction of aneurysm rupture.