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Pittsburgh researcher hope to refine understanding of aneurysms

| Saturday, July 6, 2013, 12:02 a.m.

Little is known about why one brain aneurysm might rupture while another won't — a gap in knowledge that can handicap doctors when recommending treatment.

But a research team that includes an Allegheny General Hospital surgeon and a University of Pittsburgh professor hopes to learn more about the potentially fatal condition during a two-year study funded by a $423,852 grant from the National Institutes of Health.

“We don't really understand what is happening with aneurysms in general; they're not the same in everybody, which is why some rupture and why some don't,” said Anne Robertson, professor of mechanical engineering and bioengineering at the University of Pittsburgh and a member of the research team. “In some cases, the vessel does an amazing job of keeping that big bulge intact over a lifetime. In other cases it doesn't.

“We want to know why.”

Robertson will work on the study with Dr. Khaled Aziz, director of the Center for Complex Intracranial Surgery at Allegheny General Hospital, and Juan Cebral, a professor at George Mason University who specializes in computational fluid dynamics, which studies and analyzes the flow of fluid.

They have studied 12 samples so far.

Aziz, a surgeon who treats patients with brain aneurysms, removed the aneurysms and — rather than discard the tissue, as is standard practice — sent them for further study. Under high-powered microscopes, Robertson began to detect patterns: Some vessels were strong, and thus less likely to rupture, while others were thinner and weaker and more vulnerable to rupture, which often results in death.

“The consequences of a ruptured brain aneurysm are very serious,” Aziz said. “In the last three months, I've seen at least two, if not three, people who came in with a ruptured brain aneurysm who had already died.”

The team hopes to be able to identify a vessel's makeup through safe screening processes, such as CT angiograms and MRIs.

“We want to use this data to refine our imaging techniques,” Aziz said. “We want to be able to say, this aneurysm, the wall is weak and will rupture, or this wall is strong. Right now, it's something we don't know until after we cut out the tissue and send it off.”

About 5 percent of adults suffer from brain aneurysms, Aziz said.

Treatment options range from simple observation for mild cases to surgical removal for more extreme aneurysms, Aziz said. When considering surgery, doctors consider several factors, including the patient's age and health, he said.

The rupture rate of 1 in 10,000 adults is small, but the results are extreme. Half of people who suffer a ruptured brain aneurysm die, and half of the survivors are left with a permanent disability, Aziz said.

The NIH awarded the grant based on the potential the team's research could have on improving diagnoses and treatments, according to documents provided by an NIH spokeswoman.

Chris Togneri is a staff writer for Trib Total Media. He can be reached at 412-380-5632 or ctogneri@tribweb.com.

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