Computational Fluid Dynamics for Cerebral Aneurysms in Clinical Settings

Hemodynamics is thought to play an important role in the pathogenesis of cerebral aneurysms and recent development of computer technology makes it possible to simulate blood flow using high-resolution 3D images within several hours. A lot of studies of computational fluid dynamics (CFD) for cerebral aneurysms were reported; therefore, application of CFD for cerebral aneurysms in clinical settings is reviewed in this article. CFD for cerebral aneurysms using a patient-specific geometry model was first reported in 2003 and it has been revealing that hemodynamics brings a certain contribution to understanding aneurysm pathology, including initiation, growth and rupture. Based on the knowledge of the state-of-the-art techniques, this review treats the decision-making process for using CFD in several clinical settings. We introduce our CFD procedure using digital imaging and communication in medicine (DICOM) datasets of 3D CT angiography or 3D rotational angiography. In addition, we review rupture status, hyperplastic remodeling of aneurysm wall, and recurrence of coiled aneurysms using the hemodynamic parameters such as wall shear stress (WSS), oscillatory shear index (OSI), aneurysmal inflow rate coefficient (AIRC), and residual flow volume (RFV).