In the general population, cerebral aneurysms affect 5% to 8% of people. Blood leakage into the brain as a result of blood vessel rupture could result in a deadly outcome or a major stroke. More than a quarter of individuals who have a hemorrhagic stroke pass away before getting to a medical facility.

It is very important for medical prevention and treatment to be able to predict when an aneurysm will burst. Researchers from the Indian Institute of Technology Madras and the Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, created a patient-specific mathematical model to investigate how aneurysm characteristics affect rupture risk before surgery.

Aneurysms happen when the blood vessel’s weakest spot thins, enlarges, and eventually bursts. When a cerebral aneurysm like an internal carotid artery bifurcation aneurysm happens, blood leaks into the space inside the head.

“Since clinicians encounter these aneurysms at various growth stages, it motivated us to analyze internal carotid artery aneurysms in a systematic manner,” adds B. Jayanand Sudhir, of the Sree Chitra Tirunal Institute for Medical Sciences and Technology. “The current study is a sincere and systematic attempt to address the dynamics of blood flow at various stages to understand the initiation, progression, and rupture risk.”

The team looked at the aspect ratio and size ratio of aneurysms, which give a full picture of the shape and size of the bulge. As these numbers go up and the aneurysm gets bigger, the stress on the aneurysm walls and the amount of time blood stays in the aneurysm both go up. This increases the chance of a rupture.

CT scans of the patient are put into the model, which then figures out the shape and blood flow of the aneurysm. Then, it uses mathematical equations to describe the flow of the fluid, which gives information about the walls of the blood vessels and the patterns of blood flow.

S.V. Patnaik of the Indian Institute of Technology Madras says, “This was feasible due to the access we had to the national supercomputing cluster for performing the computational fluid dynamics-based simulations.”

“The novelty of this work lies in close collaboration and amalgamation of expertise from clinical and engineering backgrounds,” adds Sudhir. “The aneurysm models were of different shapes, which helped us build and understand the complexity of flow structures in multilobed cerebral aneurysms.”

Multilobed aneurysms, which have many pockets of expanding blood like balloons, have more intricate blood flow patterns than single-lobed aneurysms.

The authors want to turn the rupture risk predictions into an easy-to-use program that will help doctors and neurosurgeons decide which high-risk patients to treat first and how to care for them. They plan to use the model to figure out how well different ways of treating aneurysms work.

Source: 10.1063/5.0117879

Image Credit: Getty

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