• Francesco Signorelli, Cyril Pailler-Mattei, Benjamin Gory, Pierre Larquet, Philip Robinson, Roberto Vargiolu, Hassan Zahouani, Paul-Emile Labeyrie, Jacques Guyotat, Isabelle Pelissou-Guyotat, Julien Berthiller, and Francis Turjman.
• Division of Neurosurgery, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University "Aldo Moro" of Bari, Bari, Italy; Division of Neurosurgery, Hospices Civils de Lyon, Lyon, France. Electronic address: francesco.signorelli@uniba.it.
• World Neurosurg. 2018 Nov 1; 119: e882-e889.

ObjectiveAneurysm wall biomechanics are not yet an integral part of aneurysm rupture risk evaluation. We aimed to develop a new technique describing the biomechanical properties of aneurysm wall and correlating them to rupture status.MethodsAneurysm wall samples collected during surgery were submitted before and after freezing to tensile tests or as fresh samples to indentation tests. The lateral stiffness or the Young's modulus of the different samples was determined as a function of the mechanical test used. The impact of freezing on biomechanical properties was evaluated. The correlation of clinical and radiologic data with the biomechanical profile of the aneurysm samples was investigated. Two-photon microscopy was used to study collagen fiber organization.ResultsSixteen aneurysm samples (11 unruptured and 5 ruptured) were included. Freezing decreased tissue stiffness. No significant difference was found between ruptured and unruptured aneurysm wall samples regarding demographic characteristics, ethnicity, smoking status, arterial hypertension, site, size and shape of the aneurysm, PHASES score, mechanical profile, or overall Young's modulus. Indentation tests found that the rupture occurred in a restricted area of increased elastic capacity and unruptured areas had increased stiffness. Two-photon microscopy found disruption of the collagen fiber network in rupture zones.ConclusionsThe indentation test of fresh aneurysm wall samples described the heterogeneity of biomechanical properties of the tissue and found increased elastic capacity in the rupture zone and increased stiffness in the remainder of the aneurysm. This study could be a basis for further research aimed at building a biomechanical-based model of aneurysm rupture risk.Copyright © 2018 Elsevier Inc. All rights reserved.

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