Prediction of impending rupture in aneurysms using 4D-CTA: histopathological verification of a real-time minimally invasive tool in unruptured aneurysms.

The authors describe the use of a 4D-CT angiogram to predict impending rupture in intact aneurysms, as a real-time, less invasive imaging technique. Histopathological verification and immunostaining of the bleb site performed on the study population reveals the significant predictive value of this tool. The point of maximum amplitude of pulsation of the aneurysm wall in unison with the RR interval of the electrocardiogram determines the potential rupture point. This helps in prioritizing the intervention for unruptured aneurysm cases, provides an effective screening of the high-risk population, and aids preoperative planning of clip application.