Investigating Delayed Rupture of Flow Diverter-Treated Giant Aneurysm Using Simulated Fluid-Structure Interactions

Area of Science:

• Biomedical Engineering
• Neurosurgery
• Medical Imaging

Background:

• Giant intracranial aneurysms pose rupture risks and often require intervention.
• Flow diverters are a primary treatment, but carry a risk of delayed rupture.
• Mechanisms of delayed rupture are poorly understood due to biomechanical complexity.

Purpose of the Study:

• To investigate the hemodynamics of giant intracranial aneurysms treated with flow diverters.
• To compare simulation results with established delayed rupture hypotheses.
• To explore the role of wall compliance in post-treatment hemodynamics.

Main Methods:

• Developed a novel fluid-structure interaction simulation.
• Utilized high-resolution rotational angiography imaging for model creation.
• Compared simulated hemodynamics to pressure rise, chaotic flow, and autolysis hypotheses.

Main Results:

• Incorporating wall compliance revealed a phase shift and dampened pressure cycles.
• Simulations showed increased flow within the aneurysm.
• Findings suggest existing delayed rupture hypotheses may need revision.

Conclusions:

• Wall compliance significantly alters hemodynamics in flow-diverted giant intracranial aneurysms.
• The study provides a foundation for improved computational modeling.
• Results necessitate re-evaluation of current hypotheses and inform clinical management strategies.