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Computational fluid dynamics based hemodynamics in the management of intracranial aneurysms: state-of-the-art

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Abstract

Intracranial aneurysms (IAs) are increasingly found in clinical practice due to widely used advanced imaging examinations. However, the mechanism of development, growth, rupture, and recurrence of IAs remains unknown. Rupture of IAs results in subarachnoid hemorrhage, which is associated with high morbidity and mortality. Assessment of intra-aneurysmal hemodynamics using computational fluid dynamics (CFD) holds great promise in the management of IAs. Hemodynamic factors have a critical role in the formation, progression, and recurrence of aneurysms, thus having great potential to guide the decision-making in clinical practice. This review describes current evidence of CFD-based hemodynamics in assessing the formation, growth, rupture, and recurrence of aneurysms. The challenges and future directions of the clinical implementations of CFD are briefly discussed.

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Abbreviations

CFD:

Computational fluid dynamics

GON:

Gradient oscillatory number

IAs:

Intracranial aneurysms

LSA:

Low WSS area

MMPs:

Matrix metalloproteinases

OSI:

Oscillatory shear index

PLc:

Pressure loss coefficient

SAH:

Subarachnoid hemorrhages

WSS:

Wall shear stress

WSSG:

WSS gradient

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Funding

This work was supported by Key Projects of the National Natural Science Foundation of China (81830057 for L.J.Z.) and the National Key Research and Development Program of China (2017YFC0113400 for L.J.Z.).

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  1. Bin Hu and Zhao Shi had equal contribution to this work.

Authors and Affiliations

  1. Department of Diagnostic Radiology , **ling Hospital, Medical School of Nan**g University, Nan**g, 210002, Jiangsu, China

    Bin Hu, Zhao Shi, U. Joseph Schoepf & Long Jiang Zhang

  2. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr., Charleston, SC, 29425-2260, USA

    U. Joseph Schoepf, Akos Varga-Szemes & W. Evans Few

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  1. Bin Hu
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Correspondence to Long Jiang Zhang.

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U. Joseph Schoepf receives institutional research support and/or personal fees from Bayer, Bracco, Elucid Bioimaging, Guerbet, HeartFlow, and Siemens. Akos Varga-Szemes receives institutional research support and/or personal fees from Elucid Bioimaging and Siemens. The other authors have no conflicts of interest to disclose.

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Hu, B., Shi, Z., Schoepf, U.J. et al. Computational fluid dynamics based hemodynamics in the management of intracranial aneurysms: state-of-the-art. Chin J Acad Radiol 4, 150–159 (2021). https://doi.org/10.1007/s42058-021-00081-3

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