Estimation of inlet flow rates for image-based aneurysm CFD models: where and how to begin?

Patient-specific flow rates are rarely available for image-based computational fluid dynamics models. Instead, flow rates are often assumed to scale according to the diameters of the arteries of interest. Our goal was to determine how choice of inlet location and scaling law affect such model-based estimation of inflow rates. We focused on 37 internal carotid artery (ICA) aneurysm cases from the Aneurisk cohort. An average ICA flow rate of 245 mL min(-1) was assumed from the literature, and then rescaled for each case according to its inlet diameter squared (assuming a fixed velocity) or cubed (assuming a fixed wall shear stress). Scaling was based on diameters measured at various consistent anatomical locations along the models. Choice of location introduced a modest 17% average uncertainty in model-based flow rate, but within individual cases estimated flow rates could vary by >100 mL min(-1). A square law was found to be more consistent with physiological flow rates than a cube law. Although impact of parent artery truncation on downstream flow patterns is well studied, our study highlights a more insidious and potentially equal impact of truncation site and scaling law on the uncertainty of assumed inlet flow rates and thus, potentially, downstream flow patterns.