Computational fluid dynamics as a risk assessment tool for aneurysm rupture

Neurosurg Focus. 2019 Jul 1;47(1):E12. doi: 10.3171/2019.4.FOCUS19189.

Abstract

Objective: The authors reviewed the clinical role of computational fluid dynamics (CFD) in assessing the risk of intracranial aneurysm rupture.

Methods: A literature review was performed to identify reports on CFD assessment of aneurysms using PubMed. The usefulness of various hemodynamic parameters, such as wall shear stress (WSS) and the Oscillatory Shear Index (OSI), and their role in aneurysm rupture risk analysis, were analyzed.

Results: The authors identified a total of 258 published articles evaluating rupture risk, growth, and endovascular device assessment. Of these 258 articles, 113 matching for CFD and hemodynamic parameters that contribute to the risk of rupture (such as WSS and OSI) were identified. However, due to a lack of standardized methodology, controversy remains on each parameter's role.

Conclusions: Although controversy continues to exist on which risk factors contribute to predict aneurysm rupture, CFD can provide additional parameters to assess this rupture risk. This technology can contribute to clinical decision-making or evaluation of efficacy for endovascular methods and devices.

Keywords: CFD = computational fluid dynamics; FD = flow diverter; FSI = fluid structure interaction; ICA = internal carotid artery; MCA = middle cerebral artery; OSI = Oscillatory Shear Index; PD = pressure difference; PLc = pressure loss coefficient; STL = stereolithography; WSS = wall shear stress; computational fluid dynamics; hemodynamics; intracranial aneurysm; rupture.

Publication types

  • Review

MeSH terms

  • Aneurysm, Ruptured / diagnosis*
  • Aneurysm, Ruptured / physiopathology*
  • Animals
  • Hemodynamics
  • Humans
  • Hydrodynamics*
  • Intracranial Aneurysm / diagnosis*
  • Intracranial Aneurysm / physiopathology*
  • Risk Assessment
  • Stress, Physiological