Help shape brain aneurysm research – take part in ROAR Study Research

Photo by Nikolay Trebukhin on Unsplash

Understanding the risk of brain aneurysm rupture: the ROAR Flow Study - Your chance to get involved and help shape brain aneurysm research

We’re delighted to be supporting new research led by Mr Frederick Ewbank, NIHR Academic Clinical Fellow in Neurosurgery at the University of Southampton, as part of the ROAR Study – the largest study of brain aneurysms in the world.

This project aims to improve how doctors predict which brain aneurysms are most likely to rupture, helping patients and clinicians make more confident decisions about treatment and monitoring.

ROAR-Flow research context

A brain aneurysm is a small swelling or bulge in a blood vessel in the brain. Most never cause any symptoms. In most cases, people live long and healthy lives without ever experiencing a problem.

However, a small number of aneurysms can burst and cause a bleed on the brain, known as a subarachnoid haemorrhage. Because of this possibility, doctors and patients often need to weigh up the pros and cons of treating an aneurysm versus monitoring it carefully over time.

Both options carry some level of risk, so clear and accurate information is vital to help people make informed choices that feel right for them.

The challenge of predicting risk of brain aneurysm rupture

The risks and benefits of aneurysm treatment are often finely balanced, and this can cause a lot of anxiety for patients.

Doctors use tools called risk prediction tools to help guide these decisions. However, these tools are limited in how well they can identify high-risk aneurysms, as they only take a small number of factors into account. Doctors may also have different views on what makes an aneurysm high risk, which can lead to variations in how care is delivered.

Many clinicians believe that the shape of an aneurysm plays a key role in rupture risk. Irregularly shaped aneurysms may have more unstable blood flow within them, increasing the chance of rupture – but current prediction tools don’t yet include this information.

Previous research has shown that analysing both the shape of an aneurysm and the blood flow inside it can improve risk prediction, but those studies have often been small and based on limited data. Most compared aneurysms that had already ruptured with those that hadn’t, rather than following patients over time.

Larger studies with long-term follow-up are now needed – and to analyse so many scans, we also need more automated techniques.

Aims of the ROAR-Flow Study

With over 20,000 patients and more than five years of follow-up, the ROAR Study provides an unprecedented opportunity to study aneurysm rupture risk.

This new NIHR doctoral fellowship project, ROAR-Flow, aims to test how measures of aneurysm shape and blood flow can be used to improve rupture prediction.

Design and methods of the brain aneurysm research

Ethical approval has been obtained to transfer, anonymise and export brain scans taken during patients’ routine care. To date, over 2,000 scans have been exported.

Using these, researchers have collaborated with engineers to develop computer software that can evaluate aneurysm shape and simulate blood flow within the aneurysm.

During this fellowship, Freddie will use this software to analyse the scans of 500 patients, including 250 whose aneurysms ruptured during follow-up. Working with computer scientists, he will then use artificial intelligence to automate the analysis and identify new patterns in aneurysm shape and blood flow.

These findings could be used to develop improved prediction tools to help doctors assess risk more accurately in the future.

Potential benefit for brain aneurysm patients

This project will identify better ways to predict aneurysm rupture. The results will give doctors and patients clearer information to guide their decisions and reduce the anxiety that so often accompanies diagnosis.

Ultimately, this research aims to improve safety, confidence and outcomes for everyone affected by a brain aneurysm.

Get involved in brain aneurysm research

As part of this work, HBA Support and the ROAR team are running a patient workshop on Thursday 4 December, 7–8.30pm (online via Zoom).

We’re inviting people affected by brain aneurysms to share their experiences and views on how imaging, risk and new technology like artificial intelligence are used in care. We’re especially keen to hear from people who have lived with a brain aneurysm, though family members and carers involved in care decisions are also welcome.

📩 To register or find out more, email: admin@hbasupport.org

More information and resources

Find out more about the ROAR Study and ROAR-Flow.

Visit our support page for free resources and patient stories from our community.

Free resources