Introduction Cerebral aneurysms may occur in 2% of the population. If an aneurysm ruptures, patients suffer from subarachnoid hemorrhage. Therefore, strategies that improve rupture risk prediction are highly warranted. Currently, several studies carried out hemodynamic simulations, but most of them mainly focused on fluid dynamics (e.g. wall shear stress; WSS). However, comprehensive evaluation of hemodynamics should include both fluid and structural aspects (fluid-structure interaction; FSI).

Aim of Study To develop a novel simulation workflow for detailed FSI analysis (>50 parameters).

Methods After simulation software development, the usability of this approach has been validated by residents and experienced neurosurgeons. In addition, we analyzed the process from growth to rupture in a patient with a middle cerebral artery aneurysm and annual imaging from 2012-2022.

Results We could successfully develop a simulation software that was implemented as part of a graphical user interface. Using this intuitive approach, it is possible for medical personnel without simulation experience to run detailed FSI simulations.

In our exemplary case, WSS was highest in 2012 and decreased during growth. In contrast, oscillatory shear index (fluid dynamics) increased over time, especially in the region of aneurysm growth. Wall stress (structural dynamics) remained constant during growth over years. However, shortly before aneurysm rupture, wall stress increased significantly.

Conclusion We could successfully develop a simulation software. The aim of this project is to integrate this simulation method in our cerebrovascular conference to improve decision making and patient care. In a next step we will perform external validation using a multi-center approach.

Disclosure of Interest no.