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Bleeding into the intraluminal thrombus in abdominal aortic aneurysms is associated with rupture

Joy Roy1, Fausto Labruto, Mats O Beckman

  • 1Department of Surgery, Capio St. Görans Hospital, Stockholm, Sweden. joy.roy@ki.se

Journal of Vascular Surgery
|September 6, 2008
PubMed

Insights

Multislice computed tomography (CT) can identify bleeding signs within abdominal aortic aneurysm (AAA) thrombus, like the crescent sign. Higher thrombus attenuation on CT is associated with AAA rupture.

Area of Science:

  • Radiology
  • Vascular Surgery
  • Medical Imaging

Background:

  • Abdominal aortic aneurysms (AAA) pose significant rupture risk.
  • Early detection of AAA rupture is critical for patient outcomes.
  • Identifying bleeding within the aneurysm thrombus may indicate impending rupture.

Purpose of the Study:

  • To evaluate multislice computed tomography (CT) for detecting signs of bleeding in the intraluminal thrombus of abdominal aortic aneurysms (AAA).
  • To determine the utility of CT in localizing the rupture site in patients with ruptured AAA.
  • To correlate CT findings with the presence and location of AAA rupture.

Main Methods:

  • Analysis of CT images from 42 patients with ruptured infrarenal AAA and 36 control patients with intact AAA.
  • Interpretation of "crescent sign" and localized hyperattenuation in thrombus as indicators of bleeding.
  • Quantification of thrombus attenuation using CT software (Hounsfield units).

Main Results:

  • The "crescent sign" was significantly more frequent in ruptured AAA (38% vs. 14%, P = .02).
  • Thrombus attenuation was significantly higher in ruptured AAA compared to intact AAA (P = .02).
  • The rupture site was identified in 29/42 patients, commonly on the left lateral wall (45%).

Conclusions:

  • Multislice CT can identify the rupture site in a majority of AAA cases.
  • Higher thrombus attenuation and the "crescent sign" are associated with AAA rupture.
  • Further research is needed to establish if these CT findings predict AAA rupture.
Abstract

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