Intramural blood pool (aorta)

Last revised by Dr Vincent Tatco on 30 Apr 2021

Intramural blood pools (IMBPs), also known as aortic branch artery pseudoaneurysms, are small foci of contrast enhancement within a recent aortic intramural hematoma seen on contrast-enhanced CTs 2. The IMBPs are more common in patients whose IMH thickness exceeds 10 mm.

Radiographic features

CT

IMBPs are located within the intramural hematoma and either do not visibly communicate with the true lumen, or do so via only a very small (< 2 mm) ostium 1. They are most frequently located within the descending thoracic and abdominal aorta in hematomas at least 10 mm in thickness 1. Additionally, they are often associated with an adjacent intercostal artery or lumbar artery 1. Less common aortic branches implicated include the bronchial arteries 2.

Treatment and prognosis

Unlike ulcer-like projections, intramural blood pool to not adversely affect prognosis, often spontaneously regress, and require no dedicated treatment 1. CTA follow up is important as occasionally endovascular coil embolization is offered to patients with enlarging symptomatic IMBPs 2.

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Figure 1: illustration
    Drag here to reorder.
  • Case 1
    Drag here to reorder.