Hemodynamic analysis of thrombosed intracranial aneurysms: a comparative correlation study

Area of Science:

• Neurosurgery
• Biomedical Engineering
• Cardiovascular Research

Background:

• Intracranial aneurysms (IA) can harbor intrasaccular thrombosis (IST), a condition whose formation mechanisms are not fully understood.
• Understanding the hemodynamic factors contributing to IST is crucial for predicting aneurysm rupture risk and guiding treatment strategies.

Purpose of the Study:

• To investigate the hemodynamic differences between thrombosed and non-thrombosed intracranial aneurysms.
• To identify specific hemodynamic features that promote intrasaccular thrombosis formation within IAs.

Main Methods:

• Computational hemodynamic analysis was performed on patient-specific intracranial aneurysm geometries derived from 3D MRI.
• 26 IAs were analyzed: 13 with intrasaccular thrombosis and 13 without, matched for size and location.
• Hemodynamic metrics including wall shear stress (WSS), flow vortex analysis, and velocity informatics were utilized.

Main Results:

• Thrombosed IAs exhibited a higher prevalence of flow eddies and greater endothelial cell activation potential (ECAP).
• Flow eddies in thrombosed IAs demonstrated more significant dynamic changes in size and location throughout the cardiac cycle.
• Increased flow stagnation and positive WSS divergence were observed in thrombosed IAs, correlating with thrombus presence.

Conclusions:

• Hemodynamic factors, specifically flow eddies, stagnation, and WSS patterns, play a significant role in the formation of intrasaccular thrombosis in intracranial aneurysms.
• These findings provide insights into the pathophysiology of IST and may inform future risk stratification models for IAs.