Development of a morphological parameter and hemodynamic analysis to assess aneurysm operability

Abstract Cerebral aneurysm is a complex vascular pathology, and the assessment of its rupture risk is often based on qualitative criteria and clinical expertise. The present study aims to develop an objective parameter to support risk evaluation by integrating morphological and hemodynamic analyses. A novel morphological parameter has been introduced, combining key geometric features extracted from 3D vessel reconstructions of middle cerebral artery bifurcations. Computational fluid dynamics (CFD) simulations were conducted to analyze hemodynamic factors such as wall shear stress and intra-aneurysmal pressure, both of which are associated with aneurysm growth and rupture risk. Particular attention was given to defining physiologically accurate boundary conditions, essential for obtaining reliable results. The new morphological parameter alignment with clinical evaluations suggesting its potential to enhance the assessment of aneurysm operability and improve surgical decision-making. This study highlights the importance of integrating morphological and hemodynamic data into the risk assessment process to refine risk stratification and guide more effective treatment strategies. Graphical Abstract