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Less than a decade ago AJNR published some of the first case studies of cerebral aneurysm hemodynamics using the then-novel combination of computational fluid dynamics (CFD) and 3D medical imaging. AJNR has since become the pre-eminent venue for such "image-based" or "patient-specific" CFD models, which have provided important clues about the roles that hemodynamic forces may play in the natural history and management of cerebral aneurysms. It is perhaps no surprise, then, that AJNR now plays host to what is arguably this young field's first real controversy, by virtue of its potential for immediate clinical and economic impacts. In last month's issue of AJNR , Fiorella et al 1 took exception to conclusions drawn by a paper published earlier this year by Cebral et al, 2 which had used image-based CFD models to show that "flow-diversion devices can cause intra-aneurysmal pressure increases, which can potentially lead to rupture, especially for giant aneurysms." Fiorella et al expressed grave concerns about the accuracy of the CFD models and the design of the study, and cautioned against any rush to judgment about the safety of these devices for certain patient populations. In their reply, Putman et al 3 vehemently defended their
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Jun 1, 2011
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