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Temporal variations of wall shear stress parameters in intracranial aneurysms—importance of patient-specific inflow waveforms for CFD calculations

  • Experimental Research
  • Published:
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Abstract

Purpose

To assess reliability of wall shear stress (WSS) calculations using computational fluid dynamics (CFD) dependent on inflow in internal carotid artery aneurysms (ICA).

Materials and methods

Six unruptured ICA aneurysms were studied. 3D computational meshes were created from 3D digital subtraction angiographic images (Axiom Artis dBA, Siemens Medical Solutions). Transient CFD simulations (Fluent, ANSYS Inc.) were performed for two inflow conditions: (1) idealized averaged waveform from normal subjects (ID) and (2) patient-specific waveform (PS) measured with 2D phase contrast magnetic resonance imaging. Stability of calculation was assessed by comparing mean WSS (<WSS>), temporal wall shear stress magnitude variation (ΔWSS), and oscillatory shear index (OSI, a measure of variation in the WSS direction) on the aneurysmal wall for both conditions.

Results

For all cases, mean relative difference (PS−ID) of WSS (<WSS>) was −15% (range −32% to 11%). Mean ΔWSS difference was −29.3% ( −100% to 67%). Mean OSI difference was 7.5% (−12% to 40%). Large variations in histograms of these parameters were noted.

Conclusion

For accurate calculations of WSS parameters, patient-specific information on physiological flow may be necessary. Results obtained with averaged or idealized flow waveforms may have to be interpreted with caution.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, The Methodist Hospital Neurological Institute, Houston, TX, USA

    Christof Karmonik, Christopher Yen & Robert G. Grossman

  2. Weil Medical College of Cornell University, New York, NY, USA

    Christof Karmonik

  3. Department of Radiology, The Methodist Hospital Neurological Institute, Houston, TX, USA

    Orlando Diaz & Richard Klucznik

  4. Department of Radiology, Baylor College of Medicine, Houston, TX, USA

    Goetz Benndorf

Authors
  1. Christof Karmonik
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  2. Christopher Yen
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  3. Orlando Diaz
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  4. Richard Klucznik
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  5. Robert G. Grossman
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  6. Goetz Benndorf
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Corresponding author

Correspondence to Christof Karmonik.

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Comment

How to identify intracranial aneurysms at risk of rupture from those that never will rupture, remains a significant clinical challenge that has very drastic implications for the life of patients with aneurysms. Recent studies of the pathobiology of the aneurysm wall, as well as the emerging field of computational hemodynamic models, have tried to develop a reliable solution for the prediction of rupture-risk.

As with all simulations and mathematical models, the main question regarding their usefulness for clinical applications is how accurately they represent the reality. In the field of computational fluid dynamics, it has been well known that the models are as accurate as their input parameters – e.g. the geometry of the vasculature and of the aneurysm, the flow conditions, and the other boundary conditions. Because accurate, non-invasive measurements for some of these parameters are difficult – especially for the inflow velocities and vectors – there is a strong urge to simplify the computational models by making generalizations and assumptions for those parameters that are too difficult to actually measure.

The study by Karmonik et al. elegantly demonstrates how important it is to have accurate, patient specific boundary conditions for the computational fluid dynamic models. Otherwise you will end up with a very elegant appearing model that has little to do with the real distribution and intensity of mechanical stress in the aneurysm, and hence might easily mislead in the clinical decision making of which aneurysm to operate, when, and what site of the aneurysm should be especially well occluded.

Juhana Frösen

Mika Niemelä

Juha Hernesniemi

Helsinki, Finland

The authors have no financial relationships to disclose.

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Karmonik, C., Yen, C., Diaz, O. et al. Temporal variations of wall shear stress parameters in intracranial aneurysms—importance of patient-specific inflow waveforms for CFD calculations. Acta Neurochir 152, 1391–1398 (2010). https://doi.org/10.1007/s00701-010-0647-0

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  • DOI: https://doi.org/10.1007/s00701-010-0647-0

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