sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20260115sibmed-2731Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯRESEARCH ARTICLESРисковый критерий роста малых церебральных аневризмThe risk criterion for the growth of small cerebral aneurysmshttps://orcid.org/0000-0001-8661-5345ТихвинскийД. В.TikhvinskiiD. V.

Тихвинский Денис Вячеславович

630090, Новосибирск, пр. Академика Лаврентьева, 15

Denis V. Tikhvinskii

630090, Novosibirsk, Akademika Lavrentieva ave., 15

d.tikhvinskii@g.nsu.ruhttps://orcid.org/0009-0007-6365-6823ЧутковД. С.ChutkovD. S.

Чутков Денис Сергеевич

630090, Новосибирск, пр. Академика Лаврентьева, 15

Denis S. Chutkov

630090, Novosibirsk, Akademika Lavrentieva ave., 15

dench123456787@mail.ruhttps://orcid.org/0000-0001-9034-2212БервицкийА. В.BervitskiyA. V.

Бервицкий Анатолий Владимирович

630087, Новосибирск, ул. Немировича-Данченко, 132/1

Anatoliy V. Bervitskiy

630087, Novosibirsk, Nemirovicha-Danchenko st., 132/1

Dr.abervitskiy@gmail.comhttps://orcid.org/0000-0002-3976-8979РезаковаМ. В.RezakovaM. V.

Резакова Мария Викторовна

630090, Новосибирск, ул. Пирогова, 25/1

Mariya V. Rezakova

630090, Novosibirsk, Pirogova st., 25/1

m.rezakova@g.nsu.ruhttps://orcid.org/0000-0002-1277-4113ТулуповА. А.TulupovA. A.

Тулупов Андрей Александрович - д.м.н., проф., чл.-корр. РАН.

630090, Новосибирск, ул. Институтская, 3а

Andrey A. Tulupov - doctor of medical sciences, professor, corresponding member of RAS.

630090, Novosibirsk, Institutskaya st., 3a

taa@tomo.nsc.ruhttps://orcid.org/0000-0002-7959-5160СтанкевичЮ. А.StankevichYu. A.

Станкевич Юлия Александровна - к.м.н.

630090, Новосибирск, ул. Институтская, 3а

Yuliya A. Stankevich - candidate of medical science.

630090, Novosibirsk, Institutskaya st., 3a

stankevich@tomo.nsc.ruhttps://orcid.org/0000-0002-2496-3042ПаршинД. В.ParshinD. V.

Паршин Даниил Васильевич - к.ф.-м.н.

630090, Новосибирск, пр. Академика Лаврентьева, 15

Daniil V. Parshin - candidate of physical and mathematical sciences.

630090, Novosibirsk, Akademika Lavrentieva ave., 15

danilo.skiman@gmail.comИнститут гидродинамики им. М.А. Лаврентьева СО РАНРоссияLavrentyev Institute of Hydrodynamics of SB RASRussian FederationФедеральный центр нейрохирургии Минздрава РоссииРоссияFederal Neurosurgical Center of Minzdrav of RussiaRussian FederationРегиональный сосудистый центр «Центральная клиническая больница»РоссияRegional Vascular Center “Central Clinical Hospital”Russian FederationИнститут «Международный томографический центр» СО РАНРоссияInternational Tomography Center of SB RASRussian Federation202619032026461165175Copyright © Тихвинский Д.В., Чутков Д.С., Бервицкий А.В., Резакова М.В., Тулупов А.А., Станкевич Ю.А., Паршин Д.В., 20262026Тихвинский Д.В., Чутков Д.С., Бервицкий А.В., Резакова М.В., Тулупов А.А., Станкевич Ю.А., Паршин Д.В.Tikhvinskii D.V., Chutkov D.S., Bervitskiy A.V., Rezakova M.V., Tulupov A.A., Stankevich Y.A., Parshin D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/2731

Церебральные аневризмы являются значимым заболеванием, которое может приводить как к инвалидизации пациента, так и к летальному исходу. Если в настоящее время достаточно хорошо развиваются технологии рискового анализа для средних по размеру и гигантских аневризм, то малые аневризмы исследованы достаточно слабо. При этом до 30 % всех разрывов фиксируется именно по средним и малым аневризмам.

Целью нашей работы было построение модели предсказания роста малых аневризм на основе динамического анализа их морфологических и гемодинамических характеристик.

Материал и методы

Материал и методы. Выполнен динамический рисковый анализ роста малых церебральных аневризм для группы пациентов одного клинического центра по данным компьютерно-томографической ангиографии. Кроме измерения динамики морфологии аневризм, также выполнена реконструкция сосудистого дерева в программе ITK Snap и рассчитана церебральная гемодинамика для 19 пациентов в программном комплексе ANSYS CFX 2020R2.

Результаты и их обсуждение. В ходе исследования получен массив данных долгосрочного наблюдения за пациентами с малыми церебральными аневризмами, на его основе построена модель логистической регрессии, которая показала площадь под ROC-кривой 0,8. Пополнение выборки обследованных пациентов позволит улучшить показатели модели, что делает ее адекватной для клинического применения.

Заключение

Заключение. Представлены уникальные данные о длительном наблюдении пациентов с малыми аневризмами. Построенная модель показала свою перспективность при условии расширения выборки пациентов.

Cerebral aneurysms are a significant disease that can lead to both disability of the patient and death. Despite the fact that risk analysis technologies for medium-sized and giant aneurysms are currently developing quite well, small aneurysms have been poorly studied. At the same time, up to 30 % of all aneurysm ruptures are recorded specifically for medium and small aneurysms.

The aim of our work was to build a model for predicting the growth of small aneurysms based on a dynamic analysis of their morphological and hemodynamic characteristics.

Material and methods

Material and methods. A dynamic risk analysis of the growth of small cerebral aneurysms was performed for a group of patients from one clinical center according to computed tomography angiography. In addition to measuring the dynamics of aneurysm morphology for the studied patients, vascular tree reconstruction was also performed in the ITK Snap program and cerebral hemodynamics was calculated for 19 patients in the ANSYS CFX 2020R2 software package.

Results and discussion

Results and discussion. During the study, an array of long-term follow-up data was obtained for patients with small cerebral aneurysms. Based on it, a logistic regression model was built, which showed area under the curve 0.8. Replenishment of the sample of examined patients will improve the performance of the model, which makes it adequate for clinical use.

Conclusions

Conclusions. The unique data on long-term follow-up of patients with small aneurysms are presented, and the constructed model has shown its promise provided that the sample of patients is expanded

церебральная аневризмарисковый анализрегрессионный анализмалые аневризмыcerebral aneurysmrisk analysisregression analysissmall aneurysmsРабота выполнена при финансовой поддержке проекта Министерства образования и науки РФ № FWGG-2021-0009. Ю.А. Станкевич, А.А. Тулупов благодарят Министерство науки и высшего образования РФ за доступ к компьютерно-томографическому оборудованию Международного томографического центра СО РАНThe work was carried out with the financial support of the project of the Ministry of Education and Science of the Russian Federation No. FWGG-2021-0009. Yu.A. Stankevich, A.A. Tulupov thank the Ministry of Science and Higher Education of the Russian Federation for access to the computed tomography scanner of the International Tomography Center of SB RASReferencesInternational Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms – risk of rupture and risk of surgical intervention. N. Engl. J. Med. 1998;339:1725–1733. doi: 10.1056/NEJM199812103392401International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms – risk of rupture and risk of surgical intervention. N. Engl. J. Med. 1998;339:1725–1733. doi: 10.1056/NEJM199812103392401Zuurbier C.C., Molenberg R., Mensing L.A., Wermer M.J., Juvela S., Lindgren A. E. Jääskeläinen J.E., Koivisto T., Yamazaki T., Uyttenboogaart M., Aalbers M.W., Morita A., Tominari S., Arai H., Nozaki K., Murayama Y., Ishibashi T., Takao H., Gondar R., Bijlenga P., Rinkel G.J.E., Greving J.P., Ruigrok Y.M. Sex difference and rupture rate of intracranial aneurysms: an individual patient data meta-analysis. Stroke. 2022;53(2):362–369. doi: 10.1161/STROKEAHA.121.035187Zuurbier C.C., Molenberg R., Mensing L.A., Wermer M.J., Juvela S., Lindgren A. E. Jääskeläinen J.E., Koivisto T., Yamazaki T., Uyttenboogaart M., Aalbers M.W., Morita A., Tominari S., Arai H., Nozaki K., Murayama Y., Ishibashi T., Takao H., Gondar R., Bijlenga P., Rinkel G.J.E., Greving J.P., Ruigrok Y.M. Sex difference and rupture rate of intracranial aneurysms: an individual patient data meta-analysis. Stroke. 2022;53(2):362–369. doi: 10.1161/STROKEAHA.121.035187Mahane K.B., Brown R.D., Meissner I., Piepgras D.G., Huston J., Zhang J., Torner J.C. Age-related differences in unruptured intracranial aneurysms: 1-year outcomes. J. Neurosurg. 2014;121(5):1024– 1038. doi: 10.3171/2014.6.JNS121179Mahane K.B., Brown R.D., Meissner I., Piepgras D.G., Huston J., Zhang J., Torner J.C. Age-related differences in unruptured intracranial aneurysms: 1-year outcomes. J. Neurosurg. 2014;121(5):1024– 1038. doi: 10.3171/2014.6.JNS121179Чугунова С.А. Этнические особенности локализации аневризм сосудов головного мозга. Неврол., нейропсихиатрия, психосоматика. 2019;11(2):60–64. doi: 10.14412/2074-2711-2019-2-60-64Chugunova S.A. Ethnic characteristics of location for cerebral aneurysms. Nevrologiya, neyropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(2):60–64. [In Russian]. doi: 10.14412/2074-2711-2019-2-60-64Becerril-Gaitan A., Mokua C., Liu C., Nguyen T., Shaker F., Nguyen J., Gusdon A.M., Brown R.J., Cochran J., Blackburn S., Chen P.R., Dannenbaum M., Choi H.A., Chen C.J. Racial and ethnic differences in mortality and functional outcomes following aneurysmal subarachnoid hemorrhage. Stroke. 2024;55(6):1572– 1581. doi: 10.1161/STROKEAHA.123.045489Becerril-Gaitan A., Mokua C., Liu C., Nguyen T., Shaker F., Nguyen J., Gusdon A.M., Brown R.J., Cochran J., Blackburn S., Chen P.R., Dannenbaum M., Choi H.A., Chen C.J. Racial and ethnic differences in mortality and functional outcomes following aneurysmal subarachnoid hemorrhage. Stroke. 2024;55(6):1572– 1581. doi: 10.1161/STROKEAHA.123.045489Toader C., Eva L., Bratu B.-G., Covache-Busuioc R.-A., Costin H.P., Dumitrascu D.-I., Glavan L.A., Corlatescu A.D., Ciurea A.V. Intracranial aneurysms and genetics: An extensive overview of genomic variations, underlying molecular dynamics, inflammatory indicators, and forward-looking insights. Brain Sci. 2023;13(10):1454. doi: 10.3390/brainsci13101454Toader C., Eva L., Bratu B.-G., Covache-Busuioc R.-A., Costin H.P., Dumitrascu D.-I., Glavan L.A., Corlatescu A.D., Ciurea A.V. Intracranial aneurysms and genetics: An extensive overview of genomic variations, underlying molecular dynamics, inflammatory indicators, and forward-looking insights. Brain Sci. 2023;13(10):1454. doi: 10.3390/brainsci13101454O’Brien Jr D., O’Dell M.W., Eversol A. Delayed traumatic cerebral aneurysm after brain injury. Arch. Phys. Med. Rehabil. 1997;78(8):883–885 doi: 10.1016/S0003-9993(97)90205-7O’Brien Jr D., O’Dell M.W., Eversol A. Delayed traumatic cerebral aneurysm after brain injury. Arch. Phys. Med. Rehabil. 1997;78(8):883–885 doi: 10.1016/S0003-9993(97)90205-7Can A., Castro V.M., Yu S., Dligach D., Finan S., Gainer,V.S., Shadick N.A., Savova G., Murphy S., Cai T., Weiss S.T., Du R. Antihyperglycemic agents are inversely associated with intracranial aneurysm rupture. Stroke. 2018;49(1):34–39 doi: 10.1161/sTROKEAHA.117.019249Can A., Castro V.M., Yu S., Dligach D., Finan S., Gainer,V.S., Shadick N.A., Savova G., Murphy S., Cai T., Weiss S.T., Du R. Antihyperglycemic agents are inversely associated with intracranial aneurysm rupture. Stroke. 2018;49(1):34–39 doi: 10.1161/sTROKEAHA.117.019249Sanchez S., Miller J.M., Samaniego E.A. Clinical scales in aneurysm rupture prediction. Stroke Vasc. Interv. Neurol. 2024;4(1):e000625. doi: 10.1161/sVIN.123.000625Sanchez S., Miller J.M., Samaniego E.A. Clinical scales in aneurysm rupture prediction. Stroke Vasc. Interv. Neurol. 2024;4(1):e000625. doi: 10.1161/sVIN.123.000625Lee G.J., Eom K.S., Lee C., Kim D.W.,Kang S.D. Rupture of very small intracranial aneurysms: incidence and clinical characteristics. J. Cerebrovasc. Endovasc. Neurosurg. 2015;17(3):217–222. doi: 10.7461/jcen.2015.17.3.217Lee G.J., Eom K.S., Lee C., Kim D.W.,Kang S.D. Rupture of very small intracranial aneurysms: incidence and clinical characteristics. J. Cerebrovasc. Endovasc. Neurosurg. 2015;17(3):217–222. doi: 10.7461/jcen.2015.17.3.217Greving J.P., Wermer M.J., Brown R.D. Jr., Morita A., Juvela S., Yonekura M., Ishibashi T., Torner J.C., Nakayama T., Rinkel G.J., Algra A. Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet. Neurol. 2014;13(1):59–66. doi: 10.1016/S14744422(13)70263-1Greving J.P., Wermer M.J., Brown R.D. Jr., Morita A., Juvela S., Yonekura M., Ishibashi T., Torner J.C., Nakayama T., Rinkel G.J., Algra A. Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet. Neurol. 2014;13(1):59–66. doi: 10.1016/S14744422(13)70263-1Neyazi B., Swiatek V.M., Skalej M., Beuing O., Stein K.P., Hattingen J., Preim B., Berg P., Saalfeld S., Sandalcioglu I.E. Rupture risk assessment for multiple intracranial aneurysms: why there is no need for dozens of clinical, morphological and hemodynamic parameters. Ther. Adv. Neurol. Disord. 2020;13:1756286420966159. doi: 10.1177/1756286420966159Neyazi B., Swiatek V.M., Skalej M., Beuing O., Stein K.P., Hattingen J., Preim B., Berg P., Saalfeld S., Sandalcioglu I.E. Rupture risk assessment for multiple intracranial aneurysms: why there is no need for dozens of clinical, morphological and hemodynamic parameters. Ther. Adv. Neurol. Disord. 2020;13:1756286420966159. doi: 10.1177/1756286420966159Тихвинский Д.В., Куянова Ю.О., Бервицкий А.В., Обединская Н.Р., Тулупов А.А., Паршин Д.В. Динамическое наблюдение изменения морфологических и гемодинамических характеристик малых церебральных аневризм. Комплекс. пробл. серд.-сосуд. заболев. 2023;12(1):172–180. doi: 10.17802/2306-1278-2023-12-1-172-180Tikhvinskii D.V., Kuyanova Yu.O., Bervitskiy A.V., Obedinskaya N.R., Tulupov A.A., Parshin D.V. Dynamic monitoring of morphological and hemodynamic evolution of small cerebral aneurysms. Kompleksnye problemy serdechno-sosudistykh zabolevaniy = Complex Issues of Cardiovascular Diseases. 2023;12(1): 172–180. [In Russian]. doi: 10.17802/2306-1278-2023-12-1-172-180Chien A., Liang F., Sayre J., Salamon N., Villablanca P., Viñuela F. Enlargement of small, asymptomatic, unruptured intracranial aneurysms in patients with no history of subarachnoid hemorrhage: the different factors related to the growth of single and multiple aneurysms. J. Neurosurg. 2013;119(1):190–197. doi: 10.3171/2013.3.JNS121469Chien A., Liang F., Sayre J., Salamon N., Villablanca P., Viñuela F. Enlargement of small, asymptomatic, unruptured intracranial aneurysms in patients with no history of subarachnoid hemorrhage: the different factors related to the growth of single and multiple aneurysms. J. Neurosurg. 2013;119(1):190–197. doi: 10.3171/2013.3.JNS121469Brinjikji W., Zhu Y.Q., Lanzino G., Cloft H.J., Murad M.H., Wang Z., Kallmes D.F. Risk factors for growth of intracranial aneurysms: a systematic review and meta-analysis. AJNR Am. J. Neuroradiol. 2016;37(4):615–620. doi: 10.3174/ajnr.A4575Brinjikji W., Zhu Y.Q., Lanzino G., Cloft H.J., Murad M.H., Wang Z., Kallmes D.F. Risk factors for growth of intracranial aneurysms: a systematic review and meta-analysis. AJNR Am. J. Neuroradiol. 2016;37(4):615–620. doi: 10.3174/ajnr.A4575Kuyanova Y.O., Chupakhin A.P., Parshin D.V., Presnyakov S.S., Dubovoi A.V. Numerical study of the tee hydrodynamics in the model problem of optimizing the low-flow vascular bypass angle. J. Appl. Mech. and Tech. Phys. 2019;60(6):1038–1045. doi: 10.1134/s0021894419060087Kuyanova Y.O., Chupakhin A.P., Parshin D.V., Presnyakov S.S., Dubovoi A.V. Numerical study of the tee hydrodynamics in the model problem of optimizing the low-flow vascular bypass angle. J. Appl. Mech. and Tech. Phys. 2019;60(6):1038–1045. doi: 10.1134/s0021894419060087Kuianova Iu.O., Dubovoy A.V., Parshin D.V. Towards the numerical assessment in solving the problem of the effectiveness of vascular anastomosis in neurosurgical operations. J. Phys.: Conf. Ser. 2019;1359:012085. doi: 10.1088/17426596/1359/1/012085Kuianova Iu.O., Dubovoy A.V., Parshin D.V. Towards the numerical assessment in solving the problem of the effectiveness of vascular anastomosis in neurosurgical operations. J. Phys.: Conf. Ser. 2019;1359:012085. doi: 10.1088/17426596/1359/1/012085Tikhvinskii D., Kuianova J., Kislitsin D., Orlov K., Gorbatykh A., Parshin D. Numerical assessment of the risk of abnormal endothelialization for diverter devices: Clinical data driven numerical study. J. Pers. Med. 2022;12(4):652. doi:10.3390/jpm12040652Tikhvinskii D., Kuianova J., Kislitsin D., Orlov K., Gorbatykh A., Parshin D. Numerical assessment of the risk of abnormal endothelialization for diverter devices: Clinical data driven numerical study. J. Pers. Med. 2022;12(4):652. doi:10.3390/jpm12040652ANSYS CFX-Solver Theory Guide. Canonsburg, 2006. Available at: http://www.ansys.com/2006ANSYS CFX-Solver Theory Guide. Canonsburg, 2006. Available at: http://www.ansys.com/2006Zarrinkoob L., Ambarki K., Wåhlin A., Birgander R., Eklund A., Malm J. Blood flow distribution in cerebral arteries. J. Cereb. Blood. Flow. Metab. 2015;35(4):648–654. doi: 10.1038/jcbfm.2014.241Zarrinkoob L., Ambarki K., Wåhlin A., Birgander R., Eklund A., Malm J. Blood flow distribution in cerebral arteries. J. Cereb. Blood. Flow. Metab. 2015;35(4):648–654. doi: 10.1038/jcbfm.2014.241Bujang M.A., Sa’at N., Bakar T.M.I.T.A., Joo L.C. Sample size guidelines for logistic regression from observational studies with large population: emphasis on the accuracy between statistics and parameters based on real life clinical data. Malays. J. Med. Sci. 2018;25(4):122‒130. doi: 10.21315/mjms2018.25.4.12Bujang M.A., Sa’at N., Bakar T.M.I.T.A., Joo L.C. Sample size guidelines for logistic regression from observational studies with large population: emphasis on the accuracy between statistics and parameters based on real life clinical data. Malays. J. Med. Sci. 2018;25(4):122‒130. doi: 10.21315/mjms2018.25.4.12Swiatek V.M., Voss S., Sprenger F., Fischer I., Kader H., Stein K.P., Schwab R., Saalfeld S., Rashidi A., Behme D., Berg P., Sandalcioglu I.E., Neyazi B. Predictive modeling and machine learning show poor performance of clinical, morphological, and hemodynamic parameters for small intracranial aneurysm rupture. Sci. Rep. 2025;15(1):24051. doi: 10.1038/s41598025-08478-1Swiatek V.M., Voss S., Sprenger F., Fischer I., Kader H., Stein K.P., Schwab R., Saalfeld S., Rashidi A., Behme D., Berg P., Sandalcioglu I.E., Neyazi B. Predictive modeling and machine learning show poor performance of clinical, morphological, and hemodynamic parameters for small intracranial aneurysm rupture. Sci. Rep. 2025;15(1):24051. doi: 10.1038/s41598025-08478-1Street S., Johnson M.D., Na J., Palmisciano P., Hoz S., Schaffer L., Shukla G., Grossman A., Smith M., Shirani P., Forbes J., Andaluz N., Dierker D., Prestigiacomo C.J. Validation of a mathematical model for rupture status of spherical intracranial aneurysms. Cardiovasc. Eng. Technol. 2025;16(4):400‒409. doi: 10.1007/s13239-025-00782-1Street S., Johnson M.D., Na J., Palmisciano P., Hoz S., Schaffer L., Shukla G., Grossman A., Smith M., Shirani P., Forbes J., Andaluz N., Dierker D., Prestigiacomo C.J. Validation of a mathematical model for rupture status of spherical intracranial aneurysms. Cardiovasc. Eng. Technol. 2025;16(4):400‒409. doi: 10.1007/s13239-025-00782-1Ru X., Zhang Z., Wang X., Liu J.Y., Zhu Y.C., Wu Z. automatic geometric quantification and rupture risk evaluation of 3D intracranial aneurysms. In: 2025 IEEE International Conference on Acoustics, Speech and Signal Processing. 2025;1–5. doi: 10.1109/ICASSP49660.2025.10888305Ru X., Zhang Z., Wang X., Liu J.Y., Zhu Y.C., Wu Z. automatic geometric quantification and rupture risk evaluation of 3D intracranial aneurysms. In: 2025 IEEE International Conference on Acoustics, Speech and Signal Processing. 2025;1–5. doi: 10.1109/ICASSP49660.2025.10888305Nagy J., Fenz W., Thumfart S., Maier J., Major Z., Stefanits H., Gollwitzer M., Oberndorfer J., Stroh N., Giretzlehner M., Sonnberger M., Gruber A., Rauch P.-R., Gmeiner M. Fluid structure Interaction analysis for rupture risk assessment in patients with middle cerebral artery aneurysms. Sci. Rep. 2025;15(1):1965. doi: 10.1038/s41598-024-85066-9Nagy J., Fenz W., Thumfart S., Maier J., Major Z., Stefanits H., Gollwitzer M., Oberndorfer J., Stroh N., Giretzlehner M., Sonnberger M., Gruber A., Rauch P.-R., Gmeiner M. Fluid structure Interaction analysis for rupture risk assessment in patients with middle cerebral artery aneurysms. Sci. Rep. 2025;15(1):1965. doi: 10.1038/s41598-024-85066-9Cui X., Zhao Y., Wang L., Jin Y., Yang Z., Li Y., Zhao Z., Zhang H., Wei K., Sun Z., Huai P., Chen L., Yang X. Prevalence, geometry, and hemodynamics of small and medium-sized intracranial aneurysms with and without blebs in the Chinese Han population. J. Cent. Nerv. Syst. Dis. 2025;17:11795735251364919. doi: 10.1177/11795735251364919Cui X., Zhao Y., Wang L., Jin Y., Yang Z., Li Y., Zhao Z., Zhang H., Wei K., Sun Z., Huai P., Chen L., Yang X. Prevalence, geometry, and hemodynamics of small and medium-sized intracranial aneurysms with and without blebs in the Chinese Han population. J. Cent. Nerv. Syst. Dis. 2025;17:11795735251364919. doi: 10.1177/11795735251364919Tang Y., Wei H., Zhang Z., Fu M., Feng J., Li Z., Liu X., Wu Y., Zhang J., Chen T., You W., Xue R., Liu A., Zhuo Y., Jiang Y., Li Y., Li R., Liu P. Separate aneurysmal neck is essential for analyzing hemodynamics and predicting instability of intracranial aneurysms. Ann. Med. 2025;57(1):2539308. doi: 10.1080/07853890.2025.2539308Tang Y., Wei H., Zhang Z., Fu M., Feng J., Li Z., Liu X., Wu Y., Zhang J., Chen T., You W., Xue R., Liu A., Zhuo Y., Jiang Y., Li Y., Li R., Liu P. Separate aneurysmal neck is essential for analyzing hemodynamics and predicting instability of intracranial aneurysms. Ann. Med. 2025;57(1):2539308. doi: 10.1080/07853890.2025.2539308Aburto-Murrieta Y., Marquez-Romero J.M., Martínez-Arellano P., Serrano-Arias F.E., Montenegro-Rosales H.A., López-Mena D. Anatomical variations of the intracranial arteries and their association with intracranial aneurysms: Insights from digital subtraction angiographies. Neuroradiol. J. 2025;19714009251313516. doi: 10.1177/19714009251313516Aburto-Murrieta Y., Marquez-Romero J.M., Martínez-Arellano P., Serrano-Arias F.E., Montenegro-Rosales H.A., López-Mena D. Anatomical variations of the intracranial arteries and their association with intracranial aneurysms: Insights from digital subtraction angiographies. Neuroradiol. J. 2025;19714009251313516. doi: 10.1177/19714009251313516Hume S, Tshimanga J.-M.I., Geoghegan P., Malan A.G., Ho W.H., Ngoepe M.N. Effect of pulsatility on the transport of thrombin in an idealized cerebral aneurysm geometry. Symmetry. 2022;14(1):133. doi: 10.3390/sym14010133Hume S, Tshimanga J.-M.I., Geoghegan P., Malan A.G., Ho W.H., Ngoepe M.N. Effect of pulsatility on the transport of thrombin in an idealized cerebral aneurysm geometry. Symmetry. 2022;14(1):133. doi: 10.3390/sym14010133Nair P., Chong B.W., Indahlastari A., Lindsay J., DeJeu D., Parthasarathy V., Ryan J., Babiker H., Workman C., Gonzalez L.F., Frakes D. Hemodynamic characterization of geometric cerebral aneurysm templates. J. Biomech. 2016;49(11):2118–2126. doi: 10.1016/j.jbiomech.2015.11.034Nair P., Chong B.W., Indahlastari A., Lindsay J., DeJeu D., Parthasarathy V., Ryan J., Babiker H., Workman C., Gonzalez L.F., Frakes D. Hemodynamic characterization of geometric cerebral aneurysm templates. J. Biomech. 2016;49(11):2118–2126. doi: 10.1016/j.jbiomech.2015.11.034Liu H., Feng W., Guan S., Li T., Mao G., Maimaitili A., Ma Y., Wang D., Ye M., Zhang H., Zhang P. Subgroup analysis of pipeline Flow-Diverter devices in the treatment of intracranial aneurysms: A long-term real-world study involving 190 patients. Neurosurg. Rev. 2025;48(1):1‒8. doi: 10.1007/s10143-025-03830-5Liu H., Feng W., Guan S., Li T., Mao G., Maimaitili A., Ma Y., Wang D., Ye M., Zhang H., Zhang P. Subgroup analysis of pipeline Flow-Diverter devices in the treatment of intracranial aneurysms: A long-term real-world study involving 190 patients. Neurosurg. Rev. 2025;48(1):1‒8. doi: 10.1007/s10143-025-03830-5Rinkel G.J., Ruigrok Y.M., Krings T., Etminan N., Vergouwen M.D. Advances in screening and management of unruptured intracranial aneurysms. Lancet Neurol. 2025;24(11):958–968. doi: 10.1016/s1474-4422(25)00265-0Rinkel G.J., Ruigrok Y.M., Krings T., Etminan N., Vergouwen M.D. Advances in screening and management of unruptured intracranial aneurysms. Lancet Neurol. 2025;24(11):958–968. doi: 10.1016/s1474-4422(25)00265-0Penchev P., Ivanov K., Milanova-Ilieva D., Gaydarski L., Kostov K., Boyadzhiev N., Petrov P.P., Mehandzhiev P., Hyusein R., Velchev V., Ilyov I., Kuzmanov V., Dzhikova G., Dobreva D., Toptchiyska L., Dimitrova V., Petrova V., Yorov S., Stanchev P., Gyulbaharov M., Husain N., Ramadanov N. Mental health and quality of life in patients with untreated unruptured intracranial aneurysms: A systematic review and meta-analysis of 417,152 patients with trial sequential analysis. Brain Sci. 2025;15(7):764. doi: 10.3390/brainsci15070764Penchev P., Ivanov K., Milanova-Ilieva D., Gaydarski L., Kostov K., Boyadzhiev N., Petrov P.P., Mehandzhiev P., Hyusein R., Velchev V., Ilyov I., Kuzmanov V., Dzhikova G., Dobreva D., Toptchiyska L., Dimitrova V., Petrova V., Yorov S., Stanchev P., Gyulbaharov M., Husain N., Ramadanov N. Mental health and quality of life in patients with untreated unruptured intracranial aneurysms: A systematic review and meta-analysis of 417,152 patients with trial sequential analysis. Brain Sci. 2025;15(7):764. doi: 10.3390/brainsci15070764Fattahi M., Abdollahi S.A., Alibak A.H., Hosseini S., Dang P. Influence of parent vessel feature on the risk of internal carotid artery aneurysm rupture via computational method. Sci. Rep. 2023;13(1):20544. doi: 10.1038/s41598-023-47927-7Fattahi M., Abdollahi S.A., Alibak A.H., Hosseini S., Dang P. Influence of parent vessel feature on the risk of internal carotid artery aneurysm rupture via computational method. Sci. Rep. 2023;13(1):20544. doi: 10.1038/s41598-023-47927-7Ma Y., Krepuska M., Madjidyar J., Schubert T., Thurner P., Kulcsar Z. Ongoing geometric remodeling of the parent artery after flow-diverter stent reconstruction in cerebral aneurysms: The device design matters. World Neurosurg. 2024;182:e597‒e601.Ma Y., Krepuska M., Madjidyar J., Schubert T., Thurner P., Kulcsar Z. Ongoing geometric remodeling of the parent artery after flow-diverter stent reconstruction in cerebral aneurysms: The device design matters. World Neurosurg. 2024;182:e597‒e601.

The authors declare that there are no conflicts of interest present.