Fluid structure Interaction analysis for rupture risk assessment in patients with middle cerebral artery aneurysms
Abstract Accurate rupture risk assessment is essential for optimizing treatment decisions in patients with cerebral aneurysms. While computational fluid dynamics (CFD) has provided critical insights into aneurysmal hemodynamics, most analyses focus on blood flow patterns, neglecting the biomechanica...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-024-85066-9 |
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| author | Jozsef Nagy Wolfgang Fenz Stefan Thumfart Julia Maier Zoltan Major Harald Stefanits Maria Gollwitzer Johannes Oberndorfer Nico Stroh Michael Giretzlehner Michael Sonnberger Andreas Gruber Philip-Rudolf Rauch Matthias Gmeiner |
| author_facet | Jozsef Nagy Wolfgang Fenz Stefan Thumfart Julia Maier Zoltan Major Harald Stefanits Maria Gollwitzer Johannes Oberndorfer Nico Stroh Michael Giretzlehner Michael Sonnberger Andreas Gruber Philip-Rudolf Rauch Matthias Gmeiner |
| author_sort | Jozsef Nagy |
| collection | DOAJ |
| description | Abstract Accurate rupture risk assessment is essential for optimizing treatment decisions in patients with cerebral aneurysms. While computational fluid dynamics (CFD) has provided critical insights into aneurysmal hemodynamics, most analyses focus on blood flow patterns, neglecting the biomechanical properties of the aneurysm wall. To address this limitation, we applied Fluid-Structure Interaction (FSI) analysis, an integrative approach that simulates the dynamic interplay between hemodynamics and wall mechanics, offering a more comprehensive risk assessment. In this study, we used advanced FSI techniques to investigate the rupture risk of middle cerebral artery bifurcation (MCA) aneurysms, analyzing a cohort of 125 patients treated for a MCA aneurysm at Kepler University Hospital, Linz, Austria. Multivariate analysis identified two significant rupture predictors: High Equivalent Stress Area (HESA; p = 0.049), which quantifies stress distribution relative to the aneurysm surface, and Gaussian curvature (GLN; p = 0.031), which captures geometric complexity. We also introduce the HGD index, a novel composite metric combining HESA, GLN, and Maximum Wall Displacement, designed to enhance predictive accuracy. With a threshold of 0.075, the HGD index exhibited excellent diagnostic performance; in internal validation, 24 of 25 ruptured aneurysms surpassed this threshold, yielding a sensitivity of 0.96. In a 5-fold cross validation the reliability of results was confirmed. Our findings demonstrate that the HGD index provides superior rupture risk stratification compared to conventional single-parameter models, offering a more robust tool for the assessment of complex aneurysmal structures. Further multicenter studies are warranted to refine and validate the HGD index, advancing its potential for clinical application and improving patient outcomes. |
| format | Article |
| id | doaj-art-070e696628974c25a8fe9996ba661900 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-070e696628974c25a8fe9996ba6619002025-01-19T12:19:02ZengNature PortfolioScientific Reports2045-23222025-01-0115111410.1038/s41598-024-85066-9Fluid structure Interaction analysis for rupture risk assessment in patients with middle cerebral artery aneurysmsJozsef Nagy0Wolfgang Fenz1Stefan Thumfart2Julia Maier3Zoltan Major4Harald Stefanits5Maria Gollwitzer6Johannes Oberndorfer7Nico Stroh8Michael Giretzlehner9Michael Sonnberger10Andreas Gruber11Philip-Rudolf Rauch12Matthias Gmeiner13eulerian-solutions e.U., Leonfeldnerstraße 245Unit Medical Informatics, RISC Software GmbHUnit Medical Informatics, RISC Software GmbHInstitute of Polymer Product Engineering, Johannes Kepler University LinzInstitute of Polymer Product Engineering, Johannes Kepler University LinzDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University LinzDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University LinzDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University LinzDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University LinzUnit Medical Informatics, RISC Software GmbHInstitute of Neuroradiology, Kepler University Hospital, Johannes Kepler UniversityDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University LinzDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University LinzDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University LinzAbstract Accurate rupture risk assessment is essential for optimizing treatment decisions in patients with cerebral aneurysms. While computational fluid dynamics (CFD) has provided critical insights into aneurysmal hemodynamics, most analyses focus on blood flow patterns, neglecting the biomechanical properties of the aneurysm wall. To address this limitation, we applied Fluid-Structure Interaction (FSI) analysis, an integrative approach that simulates the dynamic interplay between hemodynamics and wall mechanics, offering a more comprehensive risk assessment. In this study, we used advanced FSI techniques to investigate the rupture risk of middle cerebral artery bifurcation (MCA) aneurysms, analyzing a cohort of 125 patients treated for a MCA aneurysm at Kepler University Hospital, Linz, Austria. Multivariate analysis identified two significant rupture predictors: High Equivalent Stress Area (HESA; p = 0.049), which quantifies stress distribution relative to the aneurysm surface, and Gaussian curvature (GLN; p = 0.031), which captures geometric complexity. We also introduce the HGD index, a novel composite metric combining HESA, GLN, and Maximum Wall Displacement, designed to enhance predictive accuracy. With a threshold of 0.075, the HGD index exhibited excellent diagnostic performance; in internal validation, 24 of 25 ruptured aneurysms surpassed this threshold, yielding a sensitivity of 0.96. In a 5-fold cross validation the reliability of results was confirmed. Our findings demonstrate that the HGD index provides superior rupture risk stratification compared to conventional single-parameter models, offering a more robust tool for the assessment of complex aneurysmal structures. Further multicenter studies are warranted to refine and validate the HGD index, advancing its potential for clinical application and improving patient outcomes.https://doi.org/10.1038/s41598-024-85066-9Cerebral aneurysmMiddle Cerebral ArteryRupture riskFluid-structure Interaction |
| spellingShingle | Jozsef Nagy Wolfgang Fenz Stefan Thumfart Julia Maier Zoltan Major Harald Stefanits Maria Gollwitzer Johannes Oberndorfer Nico Stroh Michael Giretzlehner Michael Sonnberger Andreas Gruber Philip-Rudolf Rauch Matthias Gmeiner Fluid structure Interaction analysis for rupture risk assessment in patients with middle cerebral artery aneurysms Scientific Reports Cerebral aneurysm Middle Cerebral Artery Rupture risk Fluid-structure Interaction |
| title | Fluid structure Interaction analysis for rupture risk assessment in patients with middle cerebral artery aneurysms |
| title_full | Fluid structure Interaction analysis for rupture risk assessment in patients with middle cerebral artery aneurysms |
| title_fullStr | Fluid structure Interaction analysis for rupture risk assessment in patients with middle cerebral artery aneurysms |
| title_full_unstemmed | Fluid structure Interaction analysis for rupture risk assessment in patients with middle cerebral artery aneurysms |
| title_short | Fluid structure Interaction analysis for rupture risk assessment in patients with middle cerebral artery aneurysms |
| title_sort | fluid structure interaction analysis for rupture risk assessment in patients with middle cerebral artery aneurysms |
| topic | Cerebral aneurysm Middle Cerebral Artery Rupture risk Fluid-structure Interaction |
| url | https://doi.org/10.1038/s41598-024-85066-9 |
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