ArticleJournal of neurointerventional surgery2021
Hemodynamic conditions that favor bleb formation in cerebral aneurysms.
Article in Journal of neurointerventional surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 26 citations in OpenAlex.
- Sequential rupture of multiple intracranial aneurysms with rapidSurgical neurology international · 2026Article
- Computational Fluid Dynamics Approaches for Analyzing Rupture and Growth of Intracranial Aneurysms: A Systematic Review.Biomedicines · 2025Review
- Comparative analysis of the geometric morphology and local hemodynamics of small and medium intracranial aneurysms: a two-center retrospective study in a Chinese Han population.Quantitative imaging in medicine and surgery · 2025Article
- Intracranial Aneurysm Wall Phenotypes: Clinical, Morphological, and Hemodynamic Influences.Stroke (Hoboken, N.J.) · 2025Article
- Prevalence, Geometry, and Hemodynamics of Small and Medium-Sized Intracranial Aneurysms With and Without Blebs in the Chinese Han Population.Journal of central nervous system disease · 2025Article
- Distribution of rupture sites and blebs on intracranial aneurysm walls suggests distinct rupture patterns in ACom and MCA aneurysms.International journal for numerical methods in biomedical engineering · 2024Article
- Description of the local hemodynamic environment in intracranial aneurysm wall subdivisions.International journal for numerical methods in biomedical engineering · 2024Article
- Comapping Cellular Content and Extracellular Matrix with Hemodynamics in Intact Arterial Tissues Using Scanning Immunofluorescent Multiphoton Microscopy.Microscopy and microanalysis : the official journal of Microscopy Society of America, Microbeam Analysis Society, Microscopical Society of Canada · 2024Article
- Intracranial aneurysm wall displacement depicted by amplified Flow predicts growth.Journal of neurointerventional surgery · 2024Article
- Focal Aneurysm Wall Enhancement in Vessel Wall Imaging as a Surrogate Marker for Predicting Aneurysm Instability.Stroke (Hoboken, N.J.) · 2023Article
- Differences Between Ruptured Aneurysms With and Without Blebs: Mechanistic Implications.Cardiovascular engineering and technology · 2023Article
- Association of bleb formation with peri-aneurysmal contact in unruptured intracranial aneurysms.Scientific reports · 2022Article
- Bleb Embolization of Ruptured Cerebral Aneurysms with Coils and n-Butyl Cyanoacrylate Following Proximal Flow Control: Two Case Reports.Journal of neuroendovascular therapy · 2022Article
- Cellular responses to flow diverters in a tissue-engineered aneurysm model.Journal of neurointerventional surgery · 2021Article
- Hemodynamics in aneurysm blebs with different wall characteristics.Journal of neurointerventional surgery · 2021Article
- Analysis of Cerebral Aneurysm Wall Tension and Enhancement Using Finite Element Analysis and High-Resolution Vessel Wall Imaging.Frontiers in neurology · 2021Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAlthough it is generally believed that blebs represent weaker spots in the walls of intracranial aneurysms (IAs), it is largely unknown which aneurysm characteristics favor their development.
objectiveTo investigate possible associations between aneurysm hemodynamic and geometric characteristics and the development of blebs in intracranial aneurysms.
methodsA total of 270 IAs in 199 patients selected for surgical clipping were studied. Blebs were visually identified and interactively marked on patient-specific vascular models constructed from presurgical images. Blebs were then deleted from the vascular reconstruction to approximate the aneurysm before bleb formation. Computational fluid dynamics studies were performed in these models and in cases without blebs. Hemodynamic and geometric characteristics of aneurysms with and without blebs were compared.
resultsA total of 173 aneurysms had no blebs, while 97 aneurysms had a total of 122 blebs. Aneurysms favoring bleb formation had stronger (p<0.0001) and more concentrated inflow jets (p<0.0001), higher flow velocity (p=0.0061), more complex (p<0.0001) and unstable (p=0.0157) flow patterns, larger maximum wall shear stress (WSS; p<0.0001), more concentrated (p=0.0005) and oscillatory (p=0.0004) WSS distribution, and a more heterogeneous WSS field (p<0.0001), than aneurysms without blebs. They were also larger (p<0.0001), more elongated (p<0.0001), had wider necks (p=0.0002), and more distorted and irregular shapes (p<0.0001).
conclusionsStrong and concentrated inflow jets, high-speed, complex, and unstable flow patterns, and concentrated, oscillatory, and heterogeneous WSS patterns favor the formation of blebs in IAs. Blebs are more likely to form in large, elongated, and irregularly shaped aneurysms. These adverse characteristics could be considered signs of aneurysm instability when evaluating aneurysms for conservative observation or treatment.
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