Regarding "aneurysm rupture following treatment with flow-diverting stents: Computational hemodynamics analysis of treatment"

The conclusions presented by Cebral et al¹ are based upon results that are not only largely inconsistent with both existing experimental data and basic fluid mechanics but are selectively applied to achieve a consistent conclusion for a group of aneurysms with a known outcome (postprocedural rupture). It is important to recognize that the results or conclusions presented in the manuscript have not been validated by either dynamic angiographic data or direct physiologic measurements. These results are solely the product of mathematic simulations that are only as valid as the assumptions on which they are based. As such, we would urge the readership to exercise extreme caution before incorporating any of the concepts proposed by Cebral et al, into clinical decision-making (eg, in the selection of patients to be treated with flow-diverting devices) or into the design of clinical research studies.