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Differences Between Ruptured Aneurysms With and Without Blebs: Mechanistic Implications.

Seyedeh Fatemeh Salimi Ashkezari1, Fernando Mut2, Anne M Robertson3,4

  • 1Department of Bioengineering, Volgenau School of Engineering, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA. ssalimia@gmu.edu.

Cardiovascular Engineering and Technology
|July 12, 2022
PubMed
Summary
This summary is machine-generated.

Intracranial aneurysms (IAs) with blebs experience higher blood flow conditions, distinguishing them from IAs rupturing without blebs. Aneurysm location and morphology influence these flow dynamics and rupture characteristics.

Keywords:
BlebsHemodynamicsIntracranial aneurysmRupture

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Area of Science:

  • Neurosurgery
  • Biomedical Engineering
  • Cardiovascular Research

Background:

  • Blebs are recognized risk factors for intracranial aneurysm (IA) rupture.
  • Understanding the characteristics differentiating ruptured IAs with and without blebs is crucial for predicting rupture risk.

Purpose of the Study:

  • To analyze the distinguishing hemodynamic and geometric characteristics of intracranial aneurysms (IAs) that rupture with blebs versus those that rupture without blebs.
  • To explore potential mechanistic implications of these differences.

Main Methods:

  • A comparative analysis of 25 hemodynamic and geometric parameters was performed on 673 ruptured IAs with and without blebs.
  • Data were stratified by IA location, comparing bifurcation and sidewall aneurysms across five distinct locations.

Main Results:

  • Ruptured IAs with blebs exhibited higher flow conditions compared to those without blebs, irrespective of location.
  • Bifurcation aneurysms showed higher flow, greater wall shear stress (WSS), more concentrated WSS distribution, and more critical points than sidewall aneurysms.
  • Aneurysm morphology, including size, elongation, and shape distortion, was significantly associated with location (p < 0.01), and flow conditions varied by location.

Conclusions:

  • Aneurysm location influences morphology and subsequent flow conditions, potentially predisposing them to distinct rupture pathways, with or without bleb formation.
  • These location-specific morphological and hemodynamic variations may explain differing rupture rates and the prevalence of blebs in IAs at various sites.