• Proceedings of the Korean Society of Precision Engineering Conference
• /
• 2002.05a
• /
• pp.124-127
• /
• 2002

Ceil embolisation technique has been used to treat the intracranial aneurysms. Microcoils inserted into the aneurysm sac induce the blood flow stagnation inside the aneurysm sac, which causes the thrombus formation and embolisation of aneurysm. Since the intraaneurysmal flow patterns affect the embolisation process, we want to measure the flow field for different locations of coil inside the aneurysm sac . Lateral aneurysm models are manufactured using rapid prototyping, and the velocity fields are measured using particle image velocitimeter. Distally blocked models showed less flow into the aneurysm sac comparing to proximally blocked models. Also blocking the neck of aneurysm showed better inflow blocking comparing to blocking the dome of aneurysm. These results suggest that distal neck should be the preferred locations of coil for aneurysm embolisation.

• Journal of Biomedical Engineering Research
• /
• v.27 no.3
• /
• pp.94-100
• /
• 2006

The effectiveness of the treatment of intracranial aneurysms with endovascular coiling depends on coil packing density, the location of aneurysm, its neck dimensions with respect to the aneurysm dome, and its size with respect to the surrounding tissue. Clinical data also suggests that the aneurysm neck size is the main predictor of aneurysm recanalization. In this study, the force impinging on the aneurysm neck in an idealized aneurysm was calculated by using a three dimensional finite volume method for the non-Newtonian incompressible laminar flow. To quantify the effect of neck size on the impingement force, calculations were performed for aneurysm neck diameters (Da) varying from 10% to 100% of the parent artery diameter (Dp). Also, maximum impingement forces were represented by a function of the ratio of the aneurysm neck to the diameter of the parent vessel. The results show that the hemodynamic forces exerted on the coil mass at the aneurysm neck due to the pulsatile blood flow are larger for wide necked aneurysms.

• Journal of Korean Neurosurgical Society
• /
• v.60 no.2
• /
• pp.250-256
• /
• 2017

Objective : Cases of a ruptured pericallosal artery aneurysm with a high risk of intraoperative premature rupture and technical difficulties for proximal vascular control require a technique for the early and safe establishment of proximal vascular control. Methods : A combined pterional or subfrontal approach exposes the bilateral A1 segments or the origin of the ipsilateral A2 segment of the anterior cerebral artery (ACA) for proximal vascular control. Proximal control far from the ruptured aneurysm facilitates tentative clipping of the rupture point of the aneurysm without a catastrophic premature rupture. The proximal control is then switched to the pericallosal artery just proximal to the aneurysm and its intermittent clipping facilitates complete aneurysm dissection and neck clipping. Results : Three such cases are reported : a ruptured pericallosal artery aneurysm with a contained leak of the contrast from the proximal side of the aneurysm, a low-lying ruptured pericallosal artery aneurysm with irregularities on its proximal wall, and a multilobulated ruptured pericallosal artery aneurysm with the parasagittal bridging veins hindering surgical access to the proximal parent artery. In each case, the proposed combined pterional-interhemispheric or subfrontal-interhemispheric approach was successfully performed to establish proximal vascular control far from the ruptured aneurysm and facilitated aneurysm clipping via the interhemispheric approach. Conclusion : When using an anterior interhemispheric approach for a ruptured pericallosal artery aneurysm with a high risk of premature rupture, a pterional or subfrontal approach can be combined to establish early proximal vascular control at the bilateral A1 segments or the origin of the A2 segment.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.8
• /
• pp.1113-1120
• /
• 2000

Objectives : Despite advance in the surgical treatment of the intracranial aneurysm, we have to be surgical complication. The aim of this report is to evaluate the complication and its management in intracranial aneurysm operation. Methods : We reviewed our exprience with interesting cases of surgical complication of intracranial aneurysm : 1) rebleeding, 2) intra-operative premature rupture, 3) missed aneurysm in angiography, 4) vasospasm. Results : The risk of rebleeding was not related to the patients' initial comdition, but all other intracranial complications occurred significantly more often in patients graded poor compared with patients in good clinical condition. Rebleeding before early surgery remains as major cause of unfavorable outcome. The causes of intraoperative premature ruptures were as follows : 1) dural opening and arachnoid opening(8.3%), 2) hematoma removal(12.5%), 3) brain retraction(16.7%) 4) aneurysm dissection(62.5%). The double suction technique and primary hemostasis using a small piece of cotton or temporary clip resulted in good outcome even in cases with premature rupture. The incidence of missed aneurysm in angiography occurred in 10%. The causes were as thrombosed aneurysm, vasospasm on feeder artery. The most common missed aneurysm is also the most common aneurysm(anterior communicating artery aneurysm). The repeated angiography were documented in missed aneurysm. Balloon angioplasty is superior topapaverine for treatment of proximal vessel vasospasm by viture of a more sustained effect on the vessel. Papaverine can be useful as an adjunct to ballon angioplasty and also for the treatment of distal vessels that are not accessible for ballon angioplasty. Conclusion : The minimization of the complications and active treatment can reduced the mortality and morbidity of ruptured aneurysm patients.

• Journal of Chest Surgery
• /
• v.46 no.6
• /
• pp.467-470
• /
• 2013

The rupture of a renal artery aneurysm is a rare disease that is difficult to diagnose. Although we usually consider the appropriate treatment to be open laparotomy with aortic aneurysm surgery or stenting with graft insertion through intravascular intervention, thus far, there is no general consensus on the treatment protocol for renal artery aneurysm. Notably, ruptured renal artery aneurysm is a true critical emergency that may result in a fatal outcome. We are reporting two renal artery aneurysm patients who had ruptured and underwent emergency laparotomy.

• Journal of Chest Surgery
• /
• v.48 no.1
• /
• pp.1-6
• /
• 2015

Although development of surgical technique and critical care, ruptured abdominal aortic aneurysm still carries a high mortality. In order to obtain good results, various efforts have been attempted. This paper reviews initial management of ruptured abdominal aortic aneurysm and discuss the key point open surgical repair and endovascular aneurysm repair.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.3
• /
• pp.236-238
• /
• 2013

Rapidly developed de novo aneurysm is very rare. We present a rapidly developed and ruptured de novo anterior communicating aneurysm 8 days after the rupture of another aneurysm. This de novo aneurysm was not apparent in the initial 3-dimensional computed tomography and digital subtraction angiography. We reviewed the literature and discussed possible mechanisms for the development of this de novo aneurysm.

• Journal of Korean Neurosurgical Society
• /
• v.48 no.4
• /
• pp.354-356
• /
• 2010

Partial thrombosis of giant aneurysms is not uncommon however, complete angiographic occlusion occurs less frequently. In the case of non-giant aneurysms, complete thrombosis and recanalization has been rarely reported. A 31-year-old man presented to the emergency department with sudden bursting headache. Brain computed tomography (CT) revealed diffuse subarachnoid hemorrhage on the left side. Both CT angiography (CTA) and digital subtraction angiography showed suspicion of small left anterior choroidal artery aneurysm. We performed surgical exploration. In the operation field, anterior choroidal artery aneurysm of $2{\times}2\;mm$ with broad neck and friable appearance was observed. Because we could not clip without sacrificing the anterior choroidal artery, we performed wrapping only. Follow up CTA after 7 months demonstrated 4 mm right internal carotid artery bifurcation aneurysm. The patient underwent aneurismal neck clipping. During the operation, $9{\times}13\;mm$ sized thrombosed aneurysm was detected and completely clipped. We initially thought this aneurysm to be a de novo aneurysm however, it was an aneurysm that had recanalized from a completely thrombosed aneurysm. This case report provides an insight into the potential for complete thrombosis and recanalization of non-giant aneurysms.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.4
• /
• pp.491-499
• /
• 2000

Objective : In the cerebral aneurysm surgery, the goal is complete circulatory exclusion of the aneurysm without compromise of normal vessels. In an operating room, an operator should confirm the completeness and precision of the surgical result, before closing the wound. Object of this study was to determine which cases require intraoperative angiography. Methods : We reported our experience with 48 intraoperative angiographic studies performed during the surgical treatment of cerebral aneurysm of these 48 cases. There were 5 giant(10.4%), 15 globular(1.5-2.5cm)(31.25%) and 28 saccular(58.3%) aneurysm. We recorded the incidence of unexpected findings, such as residual aneurysms, major vessel occlusions. Using Fischer's exact test, we assessed whether unexpected angiographic findings showed any correlation with aneurysm site, size and clinical findings. Results : In 5 cases(10.4%), we detected unexpected angiographic findings which resulted in clip adjustment. By means of clip adjustment, an operator could restore the flow of two major arterial occlusion(4.2%) and also obliterate three persistent filling aneurysms(6.3%). Globular aneurysm was the only factor to predict unexpected angiographic findings(p<0.05). The subgroup of globular and giant aneurysm has a high risk of occlusion of the parent artery and its branches and/or residual aneurysm. There were two minor complications related to this procedure. Conclusion : Intraoperative assessment makes it possible to recognize and correct the technical defect. Particularly in globular aneurysm, we were able to prevent both the chance for another operation and the risk of postoperative complications.

• Journal of radiological science and technology
• /
• v.45 no.5
• /
• pp.407-412
• /
• 2022

Cerebral aneurysm coil embolization has the advantages of accurate, low patient burden, and fast recovery time, but efforts are needed to reduce dose due to the burden of exposure radiation dose during interventional procedures. In this study, the area dose product(DAP/Gy·cm²) and fluoro time(min) according to the size of the aneurysm and the location of aneurysm were investigated according to insurance recognition regulations aneurysm classification cerebral aneurysm coil embolization. According to the research method, classification according to the size and location of the aneurysm is first, the size of the aneurysm is divided into less than 4mm, more than 4mm to less than 8mm, and more than 8mm, and second, the dose to the area based on the location site (DAP/Gy·cm²) and fluoro time(min) based on the location site were observed. As a result, the location of the cerebral aneurysm procedure was found to be the Paraclinoid site. During cerebral aneurysm coil embolization, the area dose was 107 Gy·cm² and fluoro time was 47.41 minutes, showing lower results than domestic studies, and when comparing the area dose product with foreign studies, the area dose product results were similar to that of Turkey and Saudi Arabia. It is expected that it can be used as an objective analysis indicator to establish diagnostic reference levels (DRLs) and patient radiation defense guidelines according to the size of cerebral aneurysm and location of cerebral aneurysm procedures during interventional procedures.