On the major role played by the curvature of intracranial aneurysms walls in determining their mechanical response, local hemodynamics, and rupture likelihood

TL;DR

This study investigates how the curvature of intracranial aneurysm walls influences their mechanical response and hemodynamics, revealing that wall curvature correlates with stress and stretch, and may help predict rupture risk.

Contribution

The paper demonstrates that wall curvature significantly affects aneurysm stress and stretch, proposing curvature-based metrics for rupture risk assessment.

Findings

Wall curvature correlates with high stress and stretch regions.

Local curvature influences hemodynamic conditions.

Curvature could be used to predict rupture likelihood.

Abstract

The properties of intracranial aneurysms (IAs) walls are known to be driven by the underlying hemodynamics adjacent to the IA sac. Different pathways exist explaining the connections between hemodynamics and local tissue properties. The emergence of such theories is essential if one wishes to compute the mechanical response of a patient-specific IA wall and predict its rupture. Apart from the hemodynamics and tissue properties, one could assume that the mechanical response also depends on the local morphology, more specifically, the wall curvature, with larger values at highly-curved wall portions. Nonetheless, this contradicts observations of IA rupture sites more often found at the dome, where the curvature is lower. This seeming contradiction indicates a complex interaction between local hemodynamics, wall morphology, and mechanical response, which warrants further investigation. This was the main goal of this work. We accomplished this by analysing the stress and stretch fields in different regions of the wall for a sample of IAs, which have been classified based on particular local hemodynamics and local curvature. Pulsatile numerical simulations were performed using the one-way fluid-solid interaction strategy implemented in OpenFOAM (solids4foam toolbox). We found that the variable best correlated with regions of high stress and stretch was the wall curvature. Additionally, our data suggest a connection between the local curvature and local hemodynamics, indicating that the curvature is a property that could be used to assess both mechanical response and hemodynamic conditions, and, moreover, to suggest new metrics based on the curvature to predict the likelihood of rupture.