Biology and Hemodynamics of Aneurysm Rupture

Casey A Chitwood; Elizabeth D Shih; Omid Amili; Anthony S Larson; Brenda M Ogle; Patrick W Alford; Andrew W Grande

doi:10.1016/j.nec.2022.06.002

Biology and Hemodynamics of Aneurysm Rupture

Neurosurg Clin N Am. 2022 Oct;33(4):431-441. doi: 10.1016/j.nec.2022.06.002. Epub 2022 Sep 11.

Authors

Casey A Chitwood¹, Elizabeth D Shih¹, Omid Amili², Anthony S Larson³, Brenda M Ogle⁴, Patrick W Alford¹, Andrew W Grande⁵

Affiliations

¹ Department of Biomedical Engineering, University of Minnesota Twin Cities, 312 Church St. SE, 7-105 Nils Hasselmo Hall, Minneapolis, MN 55455, USA.
² Mechanical, Industrial, and Manufacturing Engineering, The University of Toledo, 2801 Bancroft St, Toledo, OH 43606, USA.
³ Department of Neurosurgery, University of Minnesota Twin Cities, MMC 96, Room D-429 Mayo Memorial Building, 420 Delaware St. SE, Minneapolis, MN 55455, USA.
⁴ Department of Biomedical Engineering, University of Minnesota Twin Cities, 312 Church St. SE, 7-105 Nils Hasselmo Hall, Minneapolis, MN 55455, USA; Stem Cell Institute, McGuire Translational Research Facility, 2001 6th Street SE, Mail Code 2873, Minneapolis, MN 55455, USA.
⁵ Department of Neurosurgery, University of Minnesota Twin Cities, MMC 96, Room D-429 Mayo Memorial Building, 420 Delaware St. SE, Minneapolis, MN 55455, USA; Stem Cell Institute, McGuire Translational Research Facility, 2001 6th Street SE, Mail Code 2873, Minneapolis, MN 55455, USA. Electronic address: grande@umn.edu.

PMID: 36229130
DOI: 10.1016/j.nec.2022.06.002

Abstract

Predicting rupture risk in intracranial aneurysms is among one of the most critical questions in vascular surgery. The processes that govern an aneurysm growth are multifaceted and complex, but may be summarized into three components: hemodynamics, biology, and mechanics. We review and connect the literature in the three disciplines, identifying considerable strides in recent history and current gaps in research. Taken together, the findings from each field elucidate how and why certain aneurysms rupture, whereas others remain stable. These parameters could eventually inform a translatable predictive model that optimizes risk evaluation and physician's decision-making in treatment options for aneurysms.

Keywords: Biology; Hemodynamics; Intracranial aneurysms; Mechanics; Predictive modeling; Rupture.

Publication types

Review

MeSH terms

Aneurysm, Ruptured* / surgery
Biology
Hemodynamics
Humans
Intracranial Aneurysm* / surgery