Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Endovascular Treatment of Cerebral Aneurysms: Technical Options in Coil Embolization

뇌동맥류의 혈관 내 치료: 코일색전술의 기술적 선택

  • Moon Hee Han (Department of Neurosurgery, VHS Medical Center)
  • 한문희 (중앙보훈병원 신경외과)
  • Received : 2019.12.21
  • Accepted : 2020.04.02
  • Published : 2020.05.01
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Abstract

Since the endosaccular coil embolization technique was introduced as an alternative for treating selected patients with aneurysms, it has become a mainstay of treatment for cerebral aneurysms. In lesions with a neck larger than the aneurysmal body, an irregular shape, or arterial branches incorporated within the sac, endovascular treatment using detachable coils are traditionally contraindicated because of technical difficulties. Coil embolization has evolved as a result of both the development of related devices and the introduction of technical improvements using various devices. Use of various technical and device options can make endovascular treatment of cerebral aneurysms safer and can widen the treatment indications. Various technical options, including the technical modification of device-assisted techniques, will be presented, and the related practical points will be discussed in this issue.

뇌동맥류 치료에 있어 분리형 코일을 이용한 혈관 내 치료는 여러 기법의 발전으로 말미암아 그 임상적용 빈도가 수술적 치료의 빈도를 능가하여 뇌동맥류의 주된 치료 방법으로 자리 잡게 되었다. 혈관 내 치료의 임상적용이 확대된 데에는 기존 코일색전술이 가진 기술적 제한점을 극복할 수 있는 여러 치료기법들의 개발에 기인한 것인데, 특히 광경동맥류를 치료할 수 있는 여러 방법이 고안되었고, 그중에서 보조적인 기구를 함께 사용하는 여러 기법이 개발되어 사용되고 있다. 이 방법들은 치료의 과정에서 동맥류 내에 삽입되는 코일의 일부가 모동맥으로 빠져나오는 것을 방지하는 기법들이며, 기술적 난이도와 시술에 따른 위험도는 각 기법에 따라, 또한 병변과 주변 혈관의 양상에 따라 서로 달라서 상황에 따라 적절한 기법을 선택할 필요가 있으며, 원칙적으로 위험도가 가장 낮은 기법을 먼저 선택하여 시도하는 것인 바람직하다. 본 기고에서는 일반적인 뇌동맥류에서 혈관 내 치료의 기본적인 기법인 코일색전술에서, 기술적 제한점을 극복하는 여러 가지 보조적인 기법과 그 기술적 응용 및 주의점에 대하여 검토하고자 한다.

Keywords

References

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