Journal of Korean Neurosurgical Society

  • 제47권3호
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  • Pages.185-190
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  • 2010
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Three-Dimensional Digital Subtraction Angiographic Evaluation of Aneurysm Remnants after Clip Placement

  • Ahn, Soon-Seob (Department of Neurosurgery, Daegu Catholic University College of Medicine) ;
  • Kim, Young-Don (Department of Neurosurgery, Daegu Catholic University College of Medicine)
  • 투고 : 2009.08.28
  • 심사 : 2010.01.31
  • 발행 : 2010.03.28
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초록

Objective : The aneurysm remnants rate was evaluated via three-dimensional digital subtraction angiography (3D-DSA) in the postoperative evaluation of clipped aneurysms. Methods : Data on surgically clipped aneurysms of anterior circulation obtained via postoperative 3D-DSA from February 2007 to March 2009 were gathered. The results of the postoperative 3D-DSA and of two-dimensional digital subtraction angiography (2D-DSA) for the detection of aneurysm remnants were compared, and an investigation was performed as to why 2D-DSA had missed some aneurysm remnants that were detected in the 3D-DSA. Various surgical factors that revealed aneurysm remnants in the 3D-DSA were also evaluated. Results : A total of 39 neck remnants of 202 clipped aneurysms (19.3%) were confirmed in 3D-DSA, and these were classified according to Sindou's classification of aneurysm remnants. Patients with only a neck remnant found in the 3D-DSA represented 17.3% (35/202 aneurysms) of the whole series, and those with a residuum of neck plus sac found in the 3D-DSA represented 1.9% (4/202 aneurysms). The causes of aneurysm remnants were no full visualization (14/39, 35.9%), parent and perforator artery protection (10/39, 25.6%), clip design problems (8/39, 20.5%), and broadnecked aneurysm (7/39, 17.9%). Conclusion : Patients with ${\leq}2$mm aneurysm remnants showed an increased risk of undetectable aneurysm remnants in the 2D-DSA. The most frequent location of the missed aneurysm in 2D-DSA was the anterior communicating artery. 3D-DSA showed more aneurysm remnants than what is indicated in the existing literature, the 2D-DSA.

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참고문헌

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피인용 문헌

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