Neurological research · 2026
Formation and rupture of intracranial aneurysms with blebs: a discriminant study using anatomical and phantom models.
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Yi Hang, Yang Zifeng, Bramlage Luke C, Ludwig Bryan R
Аннотация
BACKGROUND: Intracranial aneurysms (IAs) with bleb(s) carry a higher risk of rupture. This study aimed to investigate the hemodynamic factors driving bleb formation and subsequent IA rupture using anatomical and phantom models across various bleb scenarios.
METHODS: Anatomical models of 45 IAs with 67 bleb scenarios were reconstructed from 3D rotational angiographies. To study the pre-bleb state, phantom parental models were created by virtually removing the blebs. Hemodynamic characteristics were then evaluated using validated computational methods under physiological pulsatile flow.
RESULTS: Critical hemodynamic indicators illustrate that higher wall shear stress (WSS) was linked to IA rupture at anterior cerebral artery (ACA) bifurcation (p < 0.05), while relatively low WSS was associated with IA rupture on the internal carotid artery (ICA) (p < 0.05). Additionally, bleb initiation is significantly driven by high surface-averaged WSS (p < 0.05) and WSS gradient (p < 0.05) with lower maximum oscillatory shear index (p < 0.05).
CONCLUSIONS: Blebs most likely form near the edge of the original impacted region rather than its center. The specific hemodynamic parameters predicting IA rupture with blebs are highly location-dependent.
METHODS: Anatomical models of 45 IAs with 67 bleb scenarios were reconstructed from 3D rotational angiographies. To study the pre-bleb state, phantom parental models were created by virtually removing the blebs. Hemodynamic characteristics were then evaluated using validated computational methods under physiological pulsatile flow.
RESULTS: Critical hemodynamic indicators illustrate that higher wall shear stress (WSS) was linked to IA rupture at anterior cerebral artery (ACA) bifurcation (p < 0.05), while relatively low WSS was associated with IA rupture on the internal carotid artery (ICA) (p < 0.05). Additionally, bleb initiation is significantly driven by high surface-averaged WSS (p < 0.05) and WSS gradient (p < 0.05) with lower maximum oscillatory shear index (p < 0.05).
CONCLUSIONS: Blebs most likely form near the edge of the original impacted region rather than its center. The specific hemodynamic parameters predicting IA rupture with blebs are highly location-dependent.