Validation of hemodynamic predictors for flow diverter success: a patient-specific CFD analysis of occlusion...

Flow diverters effectively treat intracranial aneurysms by modifying hemodynamics, but predicting occlusion timelines remains challenging. We evaluated hemodynamic changes and their correlation with occlusion speed in flow diverter-treated aneurysms.

Three successfully treated aneurysms with different occlusion timelines (1, 2, and 5 months) underwent patient-specific computational fluid dynamics analysis.

All aneurysms showed substantial hemodynamic changes exceeding literature thresholds: intra-aneurysmal velocity reductions of 75-90% (versus 36% threshold) and TAWSS decreases of 80-88% (versus 35-49% for successful cases). Notably, relative residence time (RRT) increase demonstrated the strongest correlation with occlusion speed: the fastest-occluding aneurysm showed a 12,240% increase, the intermediate case showed 1,041%, and the slowest case showed 885%.

RRT increased magnitude strongly correlates with aneurysm occlusion speed, emerging as the most reliable predictor of treatment timeline. Quantitative assessment of post-treatment RRT changes could enable patient-specific prediction of occlusion timelines, potentially allowing for personalized follow-up protocols.