Commentary: Computational Fluid Dynamics in Anomalous Coronaries: Moving From Anecdote-Based to Data-Based Clinical Decision-Making

Author(s):  
Hoda Hatoum ◽  
Lakshmi Prasad Dasi ◽  
Rajesh Krishnamurthy ◽  
Silvana Molossi ◽  
Carlos M. Mery
2019 ◽  
Vol 47 (1) ◽  
pp. E12 ◽  
Author(s):  
Yuichi Murayama ◽  
Soichiro Fujimura ◽  
Tomoaki Suzuki ◽  
Hiroyuki Takao

OBJECTIVEThe authors reviewed the clinical role of computational fluid dynamics (CFD) in assessing the risk of intracranial aneurysm rupture.METHODSA literature review was performed to identify reports on CFD assessment of aneurysms using PubMed. The usefulness of various hemodynamic parameters, such as wall shear stress (WSS) and the Oscillatory Shear Index (OSI), and their role in aneurysm rupture risk analysis, were analyzed.RESULTSThe authors identified a total of 258 published articles evaluating rupture risk, growth, and endovascular device assessment. Of these 258 articles, 113 matching for CFD and hemodynamic parameters that contribute to the risk of rupture (such as WSS and OSI) were identified. However, due to a lack of standardized methodology, controversy remains on each parameter’s role.CONCLUSIONSAlthough controversy continues to exist on which risk factors contribute to predict aneurysm rupture, CFD can provide additional parameters to assess this rupture risk. This technology can contribute to clinical decision-making or evaluation of efficacy for endovascular methods and devices.


2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.


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