title: Understanding flow patterns and inflammatory status in intracranial aneurysms: Towards a personalized medicine.
abstract: Unruptured intracranial aneurysms are frequently and incidentally discovered with noninvasive imaging and the decision for preventive treatment is supported by epidemiologic and statistics data, lacking personalized argumentation about individual aneurysm behavior and inflammatory status of its wall. After a review of hemodynamic forces leading to aneurysm genesis and interaction with inflammation onset within aneurysmal wall, we will successively detail routine imaging methods for the aneurysmal wall and their respective contribution. Then, we will draw up the inventory of different experimental imaging and in vitro methods for future investigation of the aneurysmal wall. We emphasize the need for cooperation with various specialties: histopathology, genetics, and immunology in order to understand the natural history of the aneurysmal sac leading most often to stability but elsewhere to aneurysmal growth, thrombosis or rupture. A description of a research protocol devoted to aneurysmal wall inflammation and recently accepted in our university is introduced.
authors.affiliation: Department of Neuroradiology, University Hospital of Bordeaux, Bordeaux, France. Electronic address: jerome.berge@chu-bordeaux.fr.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Berge
authors.affiliation: Department of Immunology, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Blanco
authors.affiliation: Department of Genetics, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Rooryck
authors.affiliation: Department of Neuroradiology, University Hospital of Nantes, Nantes, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Boursier
authors.affiliation: Department of Neuroradiology, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: Gaultier
authors.initials: G
authors.lastname: Marnat
authors.affiliation: Department of Neuroradiology, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Gariel
authors.affiliation: Department of Neuroradiology, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wavasseur
authors.affiliation: Department of Neuroradiology, University Hospital of Nantes, Nantes, France.
authors.forename: Hubert
authors.initials: H
authors.lastname: Desal
authors.affiliation: Department of Neuroradiology, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Dousset
mesh_terms: D000818:Animals; D001158:Arteries / Q000473:pathology; D001921:Brain / Q000098:blood supply; D006439:Hemodynamics; D006801:Humans; D007249:Inflammation / Q000473:pathology; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D057285:Precision Medicine / Q000379:methods*; D013927:Thrombosis / Q000473:pathology
keywords: Endovascular treatment; Inflammation; Interventional neuroradiology; Intracranial aneurysm; Personalized medicine