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Intraoperatively, these regions are visually distinguished by a red, translucent appearance and are considered highly rupture prone. However, current imaging modalities lack the resolution to detect such vulnerable areas preoperatively. This study aimed to determine whether thin-walled regions exhibit distinct local haemodynamic profiles compared to adjacent normal-appearing wall regions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Sixteen patient-specific models of unruptured middle cerebral artery aneurysms were reconstructed from digital subtraction angiography images. Intraoperative TWRs were identified using a colour segmentation method based on Delta E metrics. Computational fluid dynamics (CFD) simulations were used to compute six haemodynamic parameters: wall shear stress (WSS), time-averaged WSS (TaWSS), oscillatory shear index (OSI), relative residence time (RRT), WSS divergence (WSSD), and pressure. Haemodynamic data were extracted from spatially localised surface patches within confirmed thin and normal regions. Linear mixed-effects models were applied to compare parameters while accounting for patient-level and intra-patient variability, using normalised values to improve model fit.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Thin regions exhibited significantly higher WSS, TaWSS, WSSD, and pressure, and reduced RRT. WSS and TaWSS were approximately 3.3% and 2.8% higher in TWRs, respectively. WSSD was 5.4% higher and RRT was 0.3% lower, suggesting faster, more divergent flow in thin regions. Pressure was modestly but significantly elevated at\u2009+\u20091.3%. No significant difference was observed in OSI between regions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Thin-walled regions in intracranial aneurysms demonstrate a distinctive haemodynamic profile characterised by stronger, sustained shear forces, greater shear divergence, and reduced residence time, suggesting a dynamic mechanical environment that promotes focal wall thinning. Our findings suggest that persistent shear-driven stress, rather than oscillatory flow, is a key haemodynamic feature of thin-walled regions and may contribute to localised aneurysm wall vulnerability.\n<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00701-025-06660-y","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T05:13:36Z","timestamp":1757135616000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Haemodynamic characteristics of thin-walled regions in intracranial aneurysms: intraoperative imaging and CFD analysis"],"prefix":"10.1007","volume":"167","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4193-948X","authenticated-orcid":false,"given":"Haveena","family":"Anbananthan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phani Kumari","family":"Paritala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9778-6158","authenticated-orcid":false,"given":"Jessica","family":"Benitez Mendieta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9896-9639","authenticated-orcid":false,"given":"Han","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9342-8804","authenticated-orcid":false,"given":"Tiago","family":"Guerzet Sardenberg Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1091-1820","authenticated-orcid":false,"given":"Zoe","family":"Dettrick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ee Shern","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1110-9207","authenticated-orcid":false,"given":"Alan","family":"Coulthard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6814-9165","authenticated-orcid":false,"given":"Zhi-Yong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4626-7280","authenticated-orcid":false,"given":"Craig","family":"Winter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,6]]},"reference":[{"issue":"1","key":"6660_CR1","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1161\/01.STR.0000252129.18605.c8","volume":"38","author":"T Aoki","year":"2007","unstructured":"Aoki T, Kataoka H, Morimoto M, Nozaki K, Hashimoto N (2007) Macrophage-derived matrix metalloproteinase-2 and -9 promote the progression of cerebral aneurysms in rats. 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The study was conducted in accordance with the Declaration of Helsinki, the National Statement on Ethical Conduct in Human Research (2007, updated 2018), and the Australian Code for the Responsible Conduct of Research (2007).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Ethics approval"}},{"value":"Informed consent was waived by Royal Brisbane and Women\u2019s Hospital Human Research Ethics Committee and the Queensland Department of Public Health (ref: Public Health Agreement #49363) due to the retrospective nature of the study and use of de-identified data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Human Ethics and Consent to Participate declarations: not applicable.This study was conducted in accordance with the Declaration of Helsinki and approved by the Royal Brisbane and Women\u2019s Hospital Human Research Ethics Committee (LNR\/2019\/QRBW\/49363) and the Queensland University of Technology (ID\/2490). A waiver of informed consent was granted due to the use of retrospective, fully de-identified imaging data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human ethics and consent to participate"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"238"}}