Computational Fluid Dynamics in Intracranial Atherosclerotic Disease

Recurrent stroke risk in intracranial atherosclerotic disease remains high despite aggressive medical therapy. While hemodynamic insufficiency appears to be a strong marker of stroke recurrence, natural history studies using various unimodal imaging modalities have shown mixed results, as they likely do not adequately capture the complex local hemodynamic environment generated by a focal stenosis. Computational fluid dynamics, a multimodal tool used to simulate fluid flow and the interactions between fluids and surfaces, has recently been used to illustrate the complex hemodynamic environment surrounding intracranial atherosclerotic lesions and to risk-stratify patients on the basis of simulated outputs. We aimed to summarize the literature pertaining to computational fluid dynamics use in intracranial atherosclerotic disease and to describe its future potential use in generating more targeted therapies.