Methodological Variability and Reporting Practices in Contemporary Patient-Specific Intracranial Aneurysm CFD Studies: A Review

Patient-specific computational fluid dynamics (CFD) is increasingly used to investigate intracranial aneurysm hemodynamics. However, differences in modeling practices can affect simulated flow fields and derived metrics, complicating interpretation and comparison. We conducted a review to characterize methodological variability and reporting across the CFD workflow. We searched PubMed, Web of Science, and Scopus from 1 January 2020 to 6 November 2025. Patient-specific saccular intracranial aneurysm CFD studies were included; idealized geometries, treatment-device simulations, and methodological comparisons were excluded. Domains included geometry reconstruction, meshing, boundary conditions, numerical implementation, temporal settings, mesh independence testing, and external validation. Among 112 studies, geometry source (92.9%) and inlet boundary conditions (91.1%) were commonly reported, whereas solver type (25.0%), minimum element count (33.9%), maximum element size (22.3%), first inflation-layer height (6.3%), and explicit mesh-independence testing (8.0%) were reported less frequently. Validation was not described in 80.4% of studies, and 8.0% reported explicit methods. Modeling patterns were broadly similar when studies were stratified by scientific purpose, while reporting gaps persisted. These studies demonstrate substantial methodological variability, incomplete reporting, and infrequent verification and validation, limiting independent appraisal and cross-study comparison of CFD-derived hemodynamic findings.