Journal of Korean Neurosurgical Society

  • 제58권3호
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  • Pages.197-204
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  • 2015
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Endovascular Treatment of Ruptured Pericallosal Artery Aneurysms

  • Ko, Jun Kyeung (Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital) ;
  • Kim, Hwan Soo (Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital) ;
  • Choi, Hyuk Jin (Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital) ;
  • Lee, Tae Hong (Department of Diagnostic Radiology, Medical Research Institute, Pusan National University Hospital) ;
  • Yun, Eun Young (Department of Biostatistics, Medical Research Institute, Pusan National University Hospital) ;
  • Choi, Chang Hwa (Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital)
  • 투고 : 2015.01.02
  • 심사 : 2015.04.13
  • 발행 : 2015.10.28
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초록

Objective : Aneurysms arising from the pericallosal artery (PA) are uncommon and challenging to treat. The aim of this study was to report our experiences of the endovascular treatment of ruptured PA aneurysms. Methods : From September 2003 to December 2013, 30 ruptured PA aneurysms in 30 patients were treated at our institution via an endovascular approach. Procedural data, clinical and angiographic results were retrospectively reviewed. Results : Regarding immediate angiographic control, complete occlusion was achieved in 21 (70.0%) patients and near-complete occlusion in 9 (30.0%). Eight procedure-related complications occurred, including intraprocedural rupture and early rebleeding in three each, and thromboembolic event in two. At last follow-up, 18 patients were independent with a modified Rankin Scale (mRS) score of 0-2, and the other 12 were either dependent or had expired (mRS score, 3-6). Adjacent hematoma was found to be associated with an increased risk of poor clinical outcome. Seventeen of 23 surviving patients underwent follow-up conventional angiography (mean, 16.5 months). Results showed stable occlusion in 14 (82.4%), minor recanalization in two (11.8%), and major recanalization, which required recoiling, in one (5.9%). Conclusion : Our experiences demonstrate that endovascular treatment for a ruptured PA aneurysms is both feasible and effective. However, periprocedural rebleedings were found to occur far more often (20.0%) than is generally suspected and to be associated with preoperative contrast retention. Analysis showed existing adjacent hematoma is predictive of a poor clinical outcome.

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참고문헌

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피인용 문헌

  1. Diagnosis and treatment of pericallosal artery aneurysms vol.52, pp.1, 2018, https://doi.org/10.1016/j.pjnns.2017.09.007
  2. Giant thrombosed aneurysm of the pericallosal artery: clinical observation, literature review vol.83, pp.4, 2019, https://doi.org/10.17116/neiro20198304174
  3. Pericallosal artery aneurysm – Case report, literature review and management outcome vol.68, pp.None, 2015, https://doi.org/10.1016/j.ijscr.2020.02.022
  4. Therapy results of pericallosal aneurysms: A retrospective unicenter study vol.10, pp.3, 2015, https://doi.org/10.4081/cp.2020.1257