Hypoxia promotes blood blister-like aneurysms development: A computational fluid dynamics study

Blood blister-like aneurysms (BBAs) are a rare and severe type of aneurysms with high mortality and morbidity. While BBAs are known to occur predominantly in plateau sections, their exact cause remains unclear. This study aims to investigate the correlation between oxygen mass transport and BBA initiation with patient-specific computational fluid dynamics (CFD) methods. A group of 12 BBA patients were enrolled. The mass transport of oxygen (O₂), time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) were analyzed. Results show that the O₂ transport rate in the region where BBA occurs is very low in for 11 out of 12 patients. This region is also associated with low TAWSS and high OSI. In conclusion, this study strongly supports that mass transport of O₂ and hemodynamics exhibit the potential to serve as a diagnostic biomarker for BBAs. Furthermore, it is important to eliminate the hypoxia region of BBA during treatment.