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This study investigated the role of the presence and thickness of ILTs in AAA ruptures by analyzing the hemodynamic environment in ruptured AAAs (RAAAs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three\u2010dimensional reconstructions from computed tomography scans were performed, and 13 RAAA cases were categorized into a no\u2010ILT group, a thin\u2010layered ILT group (thickness\u00a0&lt;\u00a03\u00a0mm), and a thick\u2010layered ILT group. The hemodynamic features of the RAAAs were assessed using computational fluid dynamics simulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The thin\u2010 and thick\u2010layered ILT groups showed significant differences in aneurysm diameters (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). The three types of AAAs ruptured at different flow regions, with different hemodynamic features: (a) the no\u2010ILT AAAs ruptured at regions of flow recirculation where velocity and wall shear stresses (WSSs) were close to zero; (b) the thin\u2010layered ILT AAAs ruptured at sites at which the dominant flow impinged the wall; and (c) the thick\u2010layered ILT AAAs ruptured at the border of the dominant flow channel and recirculation zone where the flow velocity and pressure changed dramatically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hemodynamic characteristics influence the rupture mechanisms of particular AAAs differently on the basis of the presence and thickness of ILTs. Recirculation flows and low WSSs may have negative effects by inducing local rupture or positive effects by promoting the formation of thin\u2010layered ILTs. However, eccentrically located thick\u2010layered ILTs may increase the rupture risk of small AAAs because of their location in the sac lumen, which results in chaotic flow patterns and rapid increases in flow resistance.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.13658","type":"journal-article","created":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T15:36:11Z","timestamp":1560785771000},"page":"4263-4275","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Role of intraluminal thrombus in abdominal aortic aneurysm ruptures: A hemodynamic point of view"],"prefix":"10.1002","volume":"46","author":[{"given":"Yue","family":"Qiu","sequence":"first","affiliation":[{"name":"Department of Applied Mechanics Sichuan University Chengdu 610065 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Computer Science Sichuan University of Science and Engineering Zigong Sichuan 643000 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yubo","family":"Fan","sequence":"additional","affiliation":[{"name":"Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering Beihang University Beijing 100191 P. 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