Rupture signs on computed tomography, treatment, and outcome of abdominal aortic aneurysms.
OBJECTIVE
Abdominal aortic aneurysm (AAA) rupture has a high mortality rate. Although the diagnosis of a ruptured AAA is usually straightforward, detection of impending rupture signs can be more challenging. Early diagnosis of impending AAA rupture can be lifesaving. Furthermore, differentiating between impending and complete rupture has important repercussions on patient management and prognosis. The purpose of this article is to classify and illustrate the entire spectrum of AAA rupture signs and to review current treatment options for ruptured AAAs.


METHODS
Using medical illustrations supplemented with computed tomography (CT), this essay showcases the various signs of impending rupture and ruptured AAAs. Endovascular aneurysm repair (EVAR) and open surgical repair are also discussed as treatment options for ruptured AAAs.


RESULTS
CT imaging findings of ruptured AAAs can be categorised according to location: intramural, luminal, and extraluminal. Intramural signs generally indicate impending AAA rupture, whereas luminal and extraluminal signs imply complete rupture. EVAR has emerged as an alternative and possibly less morbid method to treat ruptured AAAs.


CONCLUSIONS
AAA rupture occurs at the end of a continuum of growth and wall weakening. This review describes the CT imaging findings that may help identify impending rupture prior to complete rupture.


CONCLUSIONS
• AAA rupture occurs at the end of a continuum of growth and wall weakening. • Intramural imaging findings indicate impending AAA rupture. • Luminal and extraluminal imaging findings imply complete AAA rupture. • Some imaging findings are not specific to AAA ruptures and can be seen in other pathologies. • EVAR has emerged as an alternative and possibly less morbid method of treating ruptured AAAs.
Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Hôpital Saint-Luc, 1058 Saint-Denis, Montréal, Québec, Canada, H2X 3J4.
Kim-Nhien
KN
Vu
Youri
Y
Kaitoukov
Florence
F
Morin-Roy
Claude
C
Kauffmann
Marie-France
MF
Giroux
Eric
E
Thérasse
Gilles
G
Soulez
An
A
Tang