RT Journal Article
SR Electronic
T1 CFD: Computational Fluid Dynamics or Confounding Factor Dissemination? The Role of Hemodynamics in Intracranial Aneurysm Rupture Risk Assessment
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1849
OP 1857
DO 10.3174/ajnr.A3710
VO 35
IS 10
A1 Xiang, J.
A1 Tutino, V.M.
A1 Snyder, K.V.
A1 Meng, H.
YR 2014
UL http://www.ajnr.org/content/35/10/1849.abstract
AB SUMMARY: Image-based computational fluid dynamics holds a prominent position in the evaluation of intracranial aneurysms, especially as a promising tool to stratify rupture risk. Current computational fluid dynamics findings correlating both high and low wall shear stress with intracranial aneurysm growth and rupture puzzle researchers and clinicians alike. These conflicting findings may stem from inconsistent parameter definitions, small datasets, and intrinsic complexities in intracranial aneurysm growth and rupture. In Part 1 of this 2-part review, we proposed a unifying hypothesis: both high and low wall shear stress drive intracranial aneurysm growth and rupture through mural cell–mediated and inflammatory cell–mediated destructive remodeling pathways, respectively. In the present report, Part 2, we delineate different wall shear stress parameter definitions and survey recent computational fluid dynamics studies, in light of this mechanistic heterogeneity. In the future, we expect that larger datasets, better analyses, and increased understanding of hemodynamic-biologic mechanisms will lead to more accurate predictive models for intracranial aneurysm risk assessment from computational fluid dynamics. CFDcomputational fluid dynamicsIAintracranial aneurysmLSAlow shear-stress areaMWSSmaximum wall shear stressOSIoscillatory shear indexTAWSStime-averaged wall shear stressWSSwall shear stress