Prediction of aneurysm rupture based on computational fluid dynamics – A short review

A sudden rupture of intracranial aneurysms leads to severe subarachnoid hemorrhage (SAH). Current clinical diagnosis of aneurysm rupture is primarily based on aneurysm morphology but there is uncertainty in this method that makes diagnosis difficult for clinicians. Image-based computational fluid dynamics (CFD) has been employed recently to identify objective predictive parameters of aneurysm rupture. Several studies have suggested a correlation between wall shear stress (WSS) and aneurysm rupture but these findings have also led to conflicting conclusions. In this short review, we have examined the ability of CFD to predict the probability of rupture. In particular, we focused on the WSS controversy and an alternative parameter based on energy loss (EL) concept, as well as application of a novel fluid-structure interaction (FSI) method for predicting aneurysm rupture. While these CFD-based studies have provided invaluable information on aneurysm hemodynamics and its relation to aneurysm rupture, they are limited without better understanding of aneurysm biology. Therefore, a multi-disciplinary approach involving molecular scientists, biomechanical engineers and clinicians is required in the future for more acceptable CFD-based diagnosis