Computational fluid dynamic modeling of flow-altering surgical procedures: feasibility assessment on saccular aneurysm case study

The surgical treatment of complex intracranial aneurysms is still one of the main challenges for neurosurgeons worldwide. Computational fluid dynamics (CFD) could be used to predict different postoperative flow scenarios prior to surgery, in order to expand neurosurgeons' evaluations and guide surgical decision-making. However, this possibility has been marginally reported in the literature so far. The aim of this study was then to assess the feasibility of using CFD simulations to characterise blood flow rate, pressure and wall shear stress scenarios resulting from alternative surgical options for the treatment of complex intracranial aneurysms. In particular, three alternative surgical solutions were studied and compared to the preoperative condition on a relevant case study of saccular aneurysm. In this case, CFD results suggested the clipping of the aneurysm as the preferred choice, which is also the most common procedure for these types of lesion and coincided with neurosurgeon's choice. This case report suggests that CFD modelling can be used to predict postoperative flow in a complex aneurysm and can actually provide valuable additional information for surgical planning.