An In Vivo Pilot Study to Estimate the Swelling of the Aneurysm Wall Rabbit Model Generated with Pulsed Fluid Against the Aneurysm Wall

Overview

Journal Ann Biomed Eng

Specialty Biomedical Engineering

Date 2024 Oct 22

PMID 39436612

Authors

Guillaume Plet

Jolan Raviol

Jean-Baptiste Langlois

Salim Si-Mohamed

Helene Magoariec

Cyril Pailler-Mattei

Affiliations

Soon will be listed here.

Abstract

Purpose: This study addresses the critical issue of evaluating the risk of rupture of unruptured intracranial aneurysms (UIAs) through the assessment of the mechanical properties of the aneurysm wall. To achieve this, an original approach based on the development of an in vivo deformation device prototype (DDP) of the vascular wall is proposed. The DDP operates by pulsing a physiological fluid onto the vascular wall and measuring the resulting deformation using spectral photon counting computed tomography (SPCCT) imaging.

Methods: In this preliminary study conducted on a rabbit animal model, an aneurysm was induced on the carotid artery, followed by deformation of the aneurysm sac wall using the DDP. The change in luminal volume of the aneurysm sac induced by the deformation of the vascular wall was then quantified.

Results: The initial experimental results demonstrated an increase in the luminal volume of the aneurysm sac in relation to the increased flow rate of the fluid pulsed by the DDP onto the arterial wall. Measurement of the pressure generated by the DDP in relation to the different flow rate values imposed by the pulsation system revealed experimental values of the same order of magnitude as dynamic blood pressure. Furthermore, theoretical pressure values on the deformed area, calculated using Euler's theorem, appeared to be correlated with experimental pressure measurements.

Conclusion: This equivalence between theory and experiment is a key element in the use of the DDP for estimating the mechanical properties of the vascular wall, particularly for the use of finite element models to characterise the stress state of the deformed vascular wall. This preliminary work thus presents a novel, innovative, and promising approach for the evaluation and management of the risk of rupture of unruptured intracranial aneurysms.

References

Rinkel G, Djibuti M, Algra A, van Gijn J . Prevalence and risk of rupture of intracranial aneurysms: a systematic review. Stroke. 1998; 29(1):251-6. DOI: 10.1161/01.str.29.1.251. View

Vlak M, Algra A, Brandenburg R, Rinkel G . Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis. Lancet Neurol. 2011; 10(7):626-36. DOI: 10.1016/S1474-4422(11)70109-0. View

Kassell N, Torner J, Haley Jr E, Jane J, Adams H, Kongable G . The International Cooperative Study on the Timing of Aneurysm Surgery. Part 1: Overall management results. J Neurosurg. 1990; 73(1):18-36. DOI: 10.3171/jns.1990.73.1.0018. View

Eskesen V, Rosenorn J, Schmidt K, Espersen J, Haase J, HARMSEN A . Clinical features and outcome in 48 patients with unruptured intracranial saccular aneurysms: a prospective consecutive study. Br J Neurosurg. 1987; 1(1):47-52. DOI: 10.3109/02688698709034340. View

Rosenorn J, Eskesen V, Schmidt K, Espersen J, Haase J, HARMSEN A . [Clinical findings and prognosis in 1076 patients with ruptured intracranial saccular aneurysm. A prospective consecutive study]. Ugeskr Laeger. 1987; 149(43):2908-11. View

Williams L, Brown Jr R . Management of unruptured intracranial aneurysms. Neurol Clin Pract. 2013; 3(2):99-108. PMC: 3721237. DOI: 10.1212/CPJ.0b013e31828d9f6b. View

Nieuwkamp D, Setz L, Algra A, Linn F, de Rooij N, Rinkel G . Changes in case fatality of aneurysmal subarachnoid haemorrhage over time, according to age, sex, and region: a meta-analysis. Lancet Neurol. 2009; 8(7):635-42. DOI: 10.1016/S1474-4422(09)70126-7. View

Brown Jr R, Broderick J . Unruptured intracranial aneurysms: epidemiology, natural history, management options, and familial screening. Lancet Neurol. 2014; 13(4):393-404. DOI: 10.1016/S1474-4422(14)70015-8. View

Forget Jr T, Benitez R, Veznedaroglu E, Sharan A, Mitchell W, Silva M . A review of size and location of ruptured intracranial aneurysms. Neurosurgery. 2002; 49(6):1322-5; discussion 1325-6. DOI: 10.1097/00006123-200112000-00006. View

10.

Beck J, Rohde S, Berkefeld J, Seifert V, Raabe A . Size and location of ruptured and unruptured intracranial aneurysms measured by 3-dimensional rotational angiography. Surg Neurol. 2005; 65(1):18-25. DOI: 10.1016/j.surneu.2005.05.019. View

11.

Wiebers D, Whisnant J, Sundt Jr T, OFallon W . The significance of unruptured intracranial saccular aneurysms. J Neurosurg. 1987; 66(1):23-9. DOI: 10.3171/jns.1987.66.1.0023. View

12.

Wiebers D, Whisnant J, OFallon W . The natural history of unruptured intracranial aneurysms. N Engl J Med. 1981; 304(12):696-8. DOI: 10.1056/NEJM198103193041203. View

13.

Asano H, Horinouchi T, Mai Y, Sawada O, Fujii S, Nishiya T . Nicotine- and tar-free cigarette smoke induces cell damage through reactive oxygen species newly generated by PKC-dependent activation of NADPH oxidase. J Pharmacol Sci. 2012; 118(2):275-87. DOI: 10.1254/jphs.11166fp. View

14.

Greving J, Wermer M, Brown Jr R, Morita A, Juvela S, Yonekura M . Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet Neurol. 2013; 13(1):59-66. DOI: 10.1016/S1474-4422(13)70263-1. View

15.

Etminan N, Brown Jr R, Beseoglu K, Juvela S, Raymond J, Morita A . The unruptured intracranial aneurysm treatment score: a multidisciplinary consensus. Neurology. 2015; 85(10):881-9. PMC: 4560059. DOI: 10.1212/WNL.0000000000001891. View

16.

Proust F, Derrey S, Debono B, Gerardin E, Dujardin A, Berstein D . [Unruptured intracranial aneurysm: possible therapeutic strategies?]. Neurochirurgie. 2005; 51(5):435-54. DOI: 10.1016/s0028-3770(05)83502-7. View

17.

Spelle L, Pierot L . [Endovascular treatment of non-ruptured intracranial aneurysms: critical analysis of the literature]. J Neuroradiol. 2008; 35(2):116-20. DOI: 10.1016/j.neurad.2008.03.002. View

18.

Decq P, Bracard S, Paquis P, Pruvo J, Lejeune J, Houdart E . [Relation between neurosurgery and interventional neuroradiology]. Neurochirurgie. 2005; 51(1):47-8. DOI: 10.1016/s0028-3770(05)83423-x. View

19.

Sanchez M, Ambard D, Costalat V, Mendez S, Jourdan F, Nicoud F . Biomechanical assessment of the individual risk of rupture of cerebral aneurysms: a proof of concept. Ann Biomed Eng. 2012; 41(1):28-40. DOI: 10.1007/s10439-012-0632-2. View

20.

Texakalidis P, Sweid A, Mouchtouris N, Peterson E, Sioka C, Rangel-Castilla L . Aneurysm Formation, Growth, and Rupture: The Biology and Physics of Cerebral Aneurysms. World Neurosurg. 2019; 130:277-284. DOI: 10.1016/j.wneu.2019.07.093. View