Journal of Korean Neurosurgical Society

  • 제44권5호
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  • Pages.314-319
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  • 2008
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Multimodal Treatment for Complex Intracranial Aneurysms : Clinical Research

  • Jin, Sung-Chul (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kwon, Do-Hoon (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Young (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Hyun-Jung (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Jae-Seung (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kwun, Byung-Duk (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 발행 : 2008.11.28
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초록

Objective: For patients with giant or dissecting aneurysm, multimodal treatment consisting extracranial-intracranial bypass surgery plus clip or coil for parent artery occlusion may be necessary. In this study, the safety and efficacy of multimodal treatment in 15 patients with complex aneurysms were evaluated retrospectively. Methods: From January 1995 to June 2007, the authors treated 15 complex aneurysms that were unable to be clipped or coiled. Among them, nine patitents had unruptured aneurysms and 6 had ruptured aneurysms. Aneurysms were located in the internal cerebral artery (ICA) in 11 patients (4 in the dorsal wall. 4 in the terminal ICA, 1 in the paraclinoid, and 2 in the cavernous ICA), in the middle cerebral artery (MCA) in 2, and in the posterior circulation in two patients Results: Fifteen patients with complex aneurysms were treated with bypass surgery previously. Thirteen patients were treated with external carotid middle cerebral artery (ECA-MCA) anastomosis, and one patient with superficial temporal to posterior cerebral artery (STA-PCA) and another patient with occipital artery to posterior inferior cerebellar artery (OA-PICA) anastomosis. Parent artery occlusion was then performed with a clip in 9 patients, with a coil in 4, with balloon plus coil in one patient. All 15 aneurysms were successfully treated with clip or coil combined with bypass surgery. Follow-up angiograms showed good patency of anastomotic site in 10 out of 11 patients, and perfusion study showed sufficient perfusion in 6 out of 9 patients. Conclusion: These findings indicate that for patients with complex aneurysms, clip or coil for parent vessel occlusion with additive bypass surgery can successfully exclude the aneurysm from the neurovascular circulatory system.

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참고문헌

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피인용 문헌

  1. The Avoidance of Microsurgical Complications in the Extradural Anterior Clinoidectomy to Paraclinoid Aneurysms vol.48, pp.3, 2008, https://doi.org/10.3340/jkns.2010.48.3.199
  2. Circulatory arrest and deep hypothermia for the treatment of complex intracranial aneurysms-results from a single European center vol.152, pp.5, 2008, https://doi.org/10.1007/s00701-009-0594-9
  3. Larger inflow angle and incomplete occlusion predict recanalization of unruptured paraclinoid aneurysms after endovascular treatment vol.22, pp.4, 2008, https://doi.org/10.1177/1591019916641315
  4. Microsurgical treatment of carotid-ophthalmic aneurysm associated with multiple anterior and posterior circulation aneurysms : A case report vol.96, pp.16, 2008, https://doi.org/10.1097/md.0000000000006672
  5. Endovascular treatment of complex intracranial aneurysms vol.83, pp.None, 2018, https://doi.org/10.5114/pjr.2018.74968
  6. Microsurgical treatment of paraclinoid aneurysms by extradural anterior clinoidectomy: The fujita experience vol.14, pp.3, 2008, https://doi.org/10.4103/ajns.ajns_130_17