A Patient-specific computational fluid dynamic model of middle cerebral artery aneurysm before and one year after surgery

Computational fluid dynamics (CFD) has been widely used for studying intracranial aneurysm hemodynamics, while its use for guiding clinical strategy is still in development. In this study, CFD simulations helped inform treatment decision for a middle cerebral artery (MCA) aneurysm case was investigated. A patient with a 10.4 × 9.8 mm aneurysm attached with a small aneurysm at the edge of the trifurcation in the left MCA was included in this study. For removing the MCA aneurysm, two scenarios were considered: Plan-A involved clipping the small aneurysm and Plan-B involved clipping the whole aneurysm. A suitable treatment plan was decided by comparing the clinical measurements and CFD analysis between these two plans. One-year after the surgery, the CFD analysis was conducted again on the post-operative aneurysm model to verify the selected surgical plan in terms of morphometric and hemodynamic properties changes in the aneurysm. Based on the CFD simulation and clinical experience, surgical Plan-A was adopted. One-year after the surgery, both the hemodynamic and morphological properties improved in the post-operative aneurysm model, indicating the recovery of the patient. The patient-specific aneurysm CFD analysis can help to determine a better surgical plan for patients with special cerebral aneurysms. This study showed how CFD analysis can be used to aid clinical diagnosis and treatment.