Hemodynamic Markers: CFD-Based Prediction of Cerebral Aneurysm Rupture Risk

Abstract: This study investigates the influence of aneurysm evolution on hemodynamic characteristics within the sac region. Using computational fluid dynamics (CFD), blood flow through the parent vessel and aneurysm sac was analyzed to assess the impact on wall shear stress (WSS), time-averaged wall shear stress (TAWSS), and the oscillatory shear index (OSI), key indicators of rupture risk. Additionally, Relative Residence Time (RRT) and Endothelial Cell Activation Potential (ECAP) were examined to provide a broader understanding of the aneurysm's hemodynamic environment. Six distinct cerebral aneurysm (CA) models, all from individuals of the same gender, were selected to minimize gender-related variability. Results showed that unruptured cases exhibited higher WSS and TAWSS, along with lower OSI and RRT values patterns consistent with stable flow conditions supporting vascular integrity. In contrast, ruptured cases had lower WSS and TAWSS, coupled with elevated OSI and RRT, suggesting disturbed and oscillatory flow commonly linked to aneurysm wall weakening. ECAP was also higher in ruptured cases, indicating increased endothelial activation under unstable flow. Notably, areas with the highest OSI and RRT often aligned with vortex centers, reinforcing the association between disturbed flow and aneurysm instability. These findings highlight the value of combining multiple hemodynamic parameters for rupture risk assessment. Including RRT and ECAP provides deeper insight into flow endothelium-interactions, offering a stronger basis for evaluating aneurysm stability and guiding treatment decisions.