Formation and rupture of intracranial aneurysms with blebs: a discriminant study using anatomical and phantom models.

BACKGROUND: Intracranial aneurysms (IAs) with bleb(s) carry a higher risk of rupture. This study aimed to investigate the hemodynamic factors driving bleb formation and subsequent IA rupture using anatomical and phantom models across various bleb scenarios. METHODS: Anatomical models of 45 IAs with 67 bleb scenarios were reconstructed from 3D rotational angiographies. To study the pre-bleb state, phantom parental models were created by virtually removing the blebs. Hemodynamic characteristics were then evaluated using validated computational methods under physiological pulsatile flow. CONCLUSIONS: Blebs most likely form near the edge of the original impacted region rather than its center. The specific hemodynamic parameters predicting IA rupture with blebs are highly location-dependent.