Predicting Aneurysms? Two studies show promise

One of the greatest fears about cerebral aneurysms is their unpredictability — no one knows when it will strike, and a large majority of those living with cerebral aneurysms aren’t even aware of their existence until it’s too late.

So how do you treat something that you don’t know is there? How do you limit the risk of a ruptured aneurysm if you don’t know what will set of this potentially ticking time bomb?

Researchers and health professionals who have studied cerebral aneurysms for years are always searching for unique, innovative and safe methods of detection and care. Now, two new studies could help lead to further innovation when it comes to the treatment and care of cerebral aneurysms.

In the Netherlands, Julia Mikhal has recently published a thesis detailing a new computer modeling system that monitors blood flow in the vicinity of cerebral aneurysms. Based on this new system, Mikhal and researchers believe it possible to calculate every detail of the patient-specific situation and potentially predict further weakening or even rupture of the blood vessel’s wall, and for effective intervention.

According to University of Twente, where Dr. Mikhal teaches:

Dr. Mikhal can calculate fluid flows and the forces exerted on blood vessel walls. This allows her to perform generic model calculations and to obtain a detailed picture of individual patients’ specific situations, as a function of space and time. Flow calculations reveal which parts of the vessel wall are at greater or lesser risk of further deterioration.

Closer to home, Dr. David M. Hasan, MD, in the Department of Neurosurgery at University of Iowa Hospitals and Clinics, has recently published a study in the American Heart Association’s journal Stroke detailing how a “novel” MRI approach may indicate if a cerebral aneurysm is unstable and likely to rupture.

Dr. Hasan and his team of researchers began looking into the relationship between ferumoxytol uptake and ruptured aneurysms. Ferumoxytol, an injectable iron medication traditionally used in kidney disease patients, is also used by some doctors as a contrasting agent during MRIs for better disease characterization and diagnosis.

Dr. Hasan noted that, in the cerebral aneurysm subjects he studied, if there was an increased uptake in ferumoxytolduring the MRI process, there was a chance the aneurysm was a more severe danger than in those who experience normal and/or late uptake in the drug. According to Dr. Hasan:

Expression of … inflammatory molecules was significantly higher in aneurysms with early uptake of ferumoxytol versus aneurysms with late uptake. Uptake of ferumoxytol in aneurysm walls within the first 24 hours strongly suggests aneurysm instability and probability of rupture within 6 months, and may warrant urgent intervention.

Is it possible that, with continued studies like the ones conducted by Mikhal and Hasan, the diagnosis and treatment of cerebral aneurysms can be controlled and timed, further reducing the risk of ruptures? Only time will tell.