# Improving cerebral aneurysm risk assessment through understanding wall vulnerability andfailure modes

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $556,698

## Abstract

Description: Project Summary and Relevance
Intracranial aneurysms affect a substantial portion of the adult population. They rarely rupture, but intracranial
hemorrhage due to a ruptured brain aneurysm has devastating effects with high mortality and disability rates.
Since the risk of treatment may exceed the natural risk of rupture, there is an urgent need for a reliable method
to identify fragile aneurysms at risk of rupture that require immediate treatment and avoid unnecessary
treatment in others.
Prior work has largely focused on looking for correlations between rupture and clinically attainable quantities
such as geometry, hemodynamics and patient characteristics. However, to date, these efforts have been
promising but have not reached their full potential. Our group and others believe this is because the flow
dynamics play more than one role in wall degradation and further there are multiple modes of wall failure.
Therefore, it is extremely challenging to identify correlations without further information about the wall itself.
The proposed research is innovative in our opinion because it seeks to shift the way aneurysm pathology is
studied by turning the focus to the clinically relevant vulnerable aneurysm wall and by directly assessing the
possibly multiple mechanisms by which hemodynamics alters the wall and studying the mechanisms of
structural failure. This approach is possible because we have spent the prior R21 period i) building a
collaborative team of world leaders with diverse skills in aneurysm research, ii) acquiring all needed IRB and
MTA documents that will enable us to obtain over 350 IA domes during this program, and iii) developing the
numerous innovations in methodology that take advantage of access to an array of important experimental
facilities.
Understanding the factors that discriminate between robust aneurysm walls with well-organized collagen fibers
and vulnerable or fragile aneurysm walls with diverse changes to the collagen architecture is essential for
effective prediction of aneurysm vulnerability and design of treatments to slow or reverse this change.
Specifically, the goals of this project are: 1) determine the characteristics of structurally sound aneurysm walls,
2) determine structural causes of aneurysm wall vulnerability, 3) determine the hemodynamic conditions that
promote endothelial dysfunction and wall alteration, and 4) develop a framework for assessing risk of wall
fragility.
The contribution of the proposed work is significant because it will create a paradigm shift in how cerebral
aneurysms are studied. The focus on rupture as the end point will be shifted to wall vulnerability using methods
we developed during the R21 period. We will use this data, combined with patient characteristics, to develop a
framework for assessing risk of wall vulnerability. These results will provide he basis for a larger multi-national
trial using our framework for risk stratification.
Clinical relevance of the propose...

## Key facts

- **NIH application ID:** 9912868
- **Project number:** 5R01NS097457-05
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Anne Marie Robertson
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $556,698
- **Award type:** 5
- **Project period:** 2016-07-01 → 2021-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9912868

## Citation

> US National Institutes of Health, RePORTER application 9912868, Improving cerebral aneurysm risk assessment through understanding wall vulnerability andfailure modes (5R01NS097457-05). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/9912868. Licensed CC0.

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