The role of computational fluid dynamics in the management of unruptured intracranial aneurysms: a clinicians' view

  • Authors:

  • Pankaj K. Singh;Alberto Marzo;Stuart C. Coley;Guntram Berti;Philippe Bijlenga;Patricia V. Lawford;Mari-Cruz Villa-Uriol;Daniel A. Rufenacht;Keith M. McCormack;Alejandro Frangi;Umang J. Patel;D. Rodney Hose

  • Affiliations:

  • Departments of Medical Physics and Neurosurgery, Royal Hallamshire Hospital, Sheffield, UK;Academic Unit of Medical Physics, School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK;Department of Neuroradiology, Royal Hallamshire Hospital, Sheffield, UK;NEC Laboratories Europe, NEC Europe Ltd., St. Augustin, Germany;Clinic of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospital, Geneva, Switzerland;Academic Unit of Medical Physics, School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK;Biomedicine Communication Technologies Department, Center for Computational Imaging & Simulation Technologies, Pompeu Fabra University, Barcelona, Spain;Department of Neuroradiology, Institute of Radiology, University Hospital Basel, Petersgraben, Basel, Switzerland;Academic Unit of Medical Physics, School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK;Biomedicine Communication Technologies Department, Center for Computational Imaging & Simulation Technologies, Pompeu Fabra University, Barcelona, Spain;Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield, UK;Academic Unit of Medical Physics, School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK

  • Venue:
  • Computational Intelligence and Neuroscience
  • Year:
  • 2009

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Abstract

Objective. The importance of hemodynamics in the etiopathogenesis of intracranial aneurysms (IAs) is widely accepted. Computational fluid dynamics (CFD) is being used increasingly for hemodynamic predictions. However, alogn with the continuing development and validation of these tools, it is imperative to collect the opinion of the clinicians. Methods. A workshop on CFD was conducted during the European Society of Minimally Invasive Neurological Therapy (ESMINT) Teaching Course, Lisbon, Portugal. 36 delegates, mostly clinicians, performed supervised CFD analysis for an IA, using the @neuFuse software developed within the European project @neurIST. Feedback on the workshop was collected and analyzed. The performance was assessed on a scale of 1 to 4 and, compared with experts' performance. Results. Current dilemmas in the management of unruptured IAs remained the most important motivating factor to attend the workshop and majority of participants showed interest in participating in a multicentric trial. The participants achieved an average score of 2.52 (range 0-4) which was 63% (range 0-100%) of an expert user. Conclusions. Although participants showed a manifest interest in CFD, there was a clear lack of awareness concerning the role of hemodynamics in the etiopathogenesis of IAs and the use of CFD in this context. More efforts therefore are required to enhance understanding of the clinicians in the subject.