Role of Shear Stress in the Blister Formation of Cerebral Aneurysms

Abstract

The development of cerebral aneurysms is related to hemodynamic stress. To elucidate the role of shear stress in the blister formation of cerebral aneurysms. Among 82 aneurysms detected during catheter-based 3D rotational angiography (3DRA), 4 aneurysms enlarged with blister formation during a mean follow-up period of 10.1 month. Three of these 4 aneurysms were analyzed in this study. The regions of blister formation were characterized by comparing 3DRA before and after blister formation, and computational fluid dynamic simulations were performed based on the aneurysm geometry before blister formation. The spatially averaged shear magnitude was lower in the aneurysm region (0.97 ± 0.39 Pa) than in the parent artery (2.75 ± 0.92 Pa). The spatially averaged shear magnitude of the blister-forming area was extremely low (0.48 ± 0.12 Pa), and the shear magnitude dropped precipitately to subphysiological levels, resulting in a high shear gradient near the border of the blister-forming area. These data suggest that low shear magnitude may trigger the progression of cerebral aneurysms and that blister formation is associated with high shear gradient in the large region of low shear magnitude on the aneurysm wall.