Toward large-scale computational fluid-solid-growth models of intracranial aneurysms.

Complementary advances in medical imaging, vascular biology, genetics, biomechanics, and computational methods promise to enable the development of mathematical models of the enlargement and possible rupture of intracranial aneurysms that can help inform clinical decisions. Nevertheless, this ultimate goal is extremely challenging given the many diverse and complex factors that control the natural history of these lesions. As it should be expected, therefore, predictive models continue to develop in stages, with new advances incorporated as data and computational methods permit. In this paper, we submit that large-scale, patient-specific, fluid-solid interaction models of the entire circle of Willis and included intracranial aneurysm are both computationally tractable and necessary as a critical step toward fluid-solid-growth (FSG) models that can address the evolution of a lesion while incorporating information on the genetically and mechanobiologically determined microstructure of the wall.