CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Imaging
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1629547
This article is part of the Research TopicCardiovascular Imaging Case Reports 2025: Emphasizing Uncommon Clinical ScenariosView all 6 articles
Case Report: Preoperative Prediction of Aneurysm Rupture Site Using Aortic Morphological and Biomechanical Analysis Validated by Intraoperative Imaging
Provisionally accepted
- 1Boea Wisdom (Hangzhou) Network Technology Co. Ltd., Hangzhou, China
- 2The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- 3The University of Iowa, Iowa City, United States
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Prediction of aneurysm rupture has been a great challenge for decades. We report a successful rupture site prediction on a 97 mm abdominal aortic aneurysm (AAA). A 73-year-old man with an 11-year history of AAA presented to our outpatient clinic with a one-week history of hemoptysis. After undergoing multidimensional dynamic CTA imaging, the high rupture risk region was predicted through comprehensively inspecting the image-derived characteristics of biomechanics, morphology, and intraluminal thrombus distribution. Owing to financial difficulties, the patient declined treatment. The patient returned to the hospital 140 days later with severe acute abdominal pain. Follow-up CT imaging revealed contrast extravasation accompanied by a large retroperitoneal hematoma, indicating active aneurysmal rupture. Emergency endovascular aneurysm repair (EVAR) was subsequently performed. Notably, the rupture site corresponded to the region previously predicted by our biomechanical analysis and was confirmed intraoperatively via digital subtraction angiography. The patient's postoperative course was uneventful, and he remained in stable condition at the 3-month follow-up. This successful prediction serves as a starting point for verifying the considerations regarding aneurysm rupture mechanism, which would benefits innovative treatment options in future.
Keywords: Aneurysm rupture prediction, Biomechanical Analysis, multidimensional dynamic CTA, Multimodal Imaging, Abdominal Aortic Aneurysm
Received: 16 May 2025; Accepted: 04 Aug 2025.
Copyright: © 2025 Huang, Pan, Lin, Luo and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yuanming Luo, The University of Iowa, Iowa City, United States
Bing Chen, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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