title: The blood flow channel index as novel predictor of abdominal aortic aneurysm impending rupture based on the intraluminal thrombus angio-CT study.
abstract: OBJECTIVE
  In this study the hypothesis that the thickness of the thinnest part of the thrombus, combined with bleeding into the intraluminal thrombus (ILT), is associated with a possible higher risk of abdominal aortic aneurysm (AAA) rupture was investigated, independently of aneurysm diameter, by using angio-CT. This article describes blood flow channel index based on the CT imaging findings that may help identify impending rupture prior to complete rupture.
  
  
  METHODS
  Computed tomographic images of 310 hospitalized patients with infrarenal AAA, were collected over a three-year period. They were divided into two main groups: 125 with bleeding into the ILT and control group 185 without the presence of blood in the thrombus. Patients were also analyzed in subgroups with ruptured, symptomatic and asymptomatic AAAs. A blood flow channel index was formulated as: maximal/minimal thickness ratio of thrombus from the same CT scan.
  
  
  RESULTS
  In dissected ILT group blood flow channel index was over a twofold higher than in group with intact ILT (19.0 [1.2-89.3] vs. (9.7 [1.3-38.9]; p<0.001), respectively. Median thickness at the thinnest part of the ILT in dissected thrombus group was lower (1.3mm [0.3-16.0]) than in group with intact ILT (1.7 mm [0.2-23.4]; p<0.003).
  
  
  CONCLUSIONS
  An association between a high blood flow channel index and bleeding into the ILT based on angio-CT study was demonstrated, and can suggest the aneurysm propensity for rupture.
authors: Department of Vascular Surgery and Angiology, Pomeranian Medical University, Szczecin, Poland. Electronic address: irekwie@wp.eu.
authors: Ireneusz
authors: I
authors: Wiernicki
authors: Department of Vascular Surgery and Angiology, Pomeranian Medical University, Szczecin, Poland.
authors: Pawel
authors: P
authors: Szumilowicz
authors: Department of Vascular Surgery and Angiology, Pomeranian Medical University, Szczecin, Poland.
authors: Arkadiusz
authors: A
authors: Kazimierczak
authors: Department of Interventional Radiology, Pomeranian Medical University, Szczecin, Poland.
authors: Aleksander
authors: A
authors: Falkowski
authors: Department of Interventional Radiology, Pomeranian Medical University, Szczecin, Poland.
authors: Donald
authors: D
authors: Rutkowski
authors: Department of Vascular Surgery and Angiology, Pomeranian Medical University, Szczecin, Poland.
authors: Piotr
authors: P
authors: Gutowski
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging*; D001019:Aortic Rupture / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006439:Hemodynamics; D006470:Hemorrhage; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Abdominal aortic aneurysm; Blood flow channel index; Computed tomography imaging; Intraluminal thrombus