Computational Fluid Dynamics Approaches for Analyzing Rupture and Growth of Intracranial Aneurysms: A Systematic...

Area of Science:

• Biomedical Engineering
• Medical Imaging
• Fluid Dynamics

Background:

• Hemodynamic stressors like abnormal wall shear stress and oscillatory shear index are implicated in intracranial aneurysm (IA) pathogenesis, growth, and rupture.
• Computational fluid dynamics (CFD) is a vital tool for quantitatively assessing these hemodynamic factors in IAs.

Purpose of the Study:

• To systematically review recent CFD studies on human saccular aneurysms.
• To identify frequently analyzed hemodynamic and morphological parameters.
• To summarize the methodological strategies used in these CFD analyses.

Main Methods:

• Systematic review following PRISMA guidelines (2019-2024).
• Searched PubMed, Scopus, Web of Science, and Embase databases.
• Included studies using CFD on human saccular aneurysms related to rupture or growth, excluding idealized models and non-human analyses.

Main Results:

• Thirty-five studies met criteria; commercial software dominated CFD processes.
• Frequently analyzed hemodynamic parameters: oscillatory shear index (OSI, 91.43%), time-averaged wall shear stress (TAWSS, 71.43%), low shear area ratio (LSAR, 60.00%), normalized wall shear stress (NWSS, 51.43%), and relative residence time (RRT, 45.71%).
• Key morphological parameters: aspect ratio (AR, 74.29%), size ratio (SR, 68.57%), and volume (42.86%) showed strong associations with IA rupture and growth.

Conclusions:

• A core set of parameters (AR, SR, TAWSS, OSI, RRT, LSAR) consistently predicts IA rupture and growth.
• Methodological heterogeneity and lack of unified standards impede reproducibility and clinical translation.
• Standardization of computational frameworks, parameter definitions, and boundary conditions is urgently needed for clinical applicability of CFD in IA risk assessment.