• 대한의용생체공학회:의공학회지
• /
• 제22권6호
• /
• pp.535-542
• /
• 2001

스텐트를 이용한 동맥류 색전술은 방추형 동맥류 등 목이 넓은 광경동맥류의 치료에 최근 사용되고 있다. 동맥류 내부의 혈류유동은 혈전의 형성 및 동맥류 폐색에 중요한 역할을 하므로 스텐트의 삽입으로 인한 동맥류 내부 혈류 유동의 변화를 고찰하기 위하여 광색성 염료를 이용한 유동가시화 방법을 사용하였다. 제작된 방추형 동맥류 모델에 대해 맥동 유동시 동맥류 벽 다섯 위치에서 유동장의 정성적 관탈 및 벽 전단변형률의 측정이 수행되었다. 스텐트의 삽입은 동맥류 내부의 유동을 감소시켰으며 동맥류 내부의 느린 와류유동이 감속후기가지 지속되었다. 또한 스텐트가 삽입된 모델은 스텐트가 없는 모델에 비하여 벽 전단변형률이 감소하였으며. OSI는 증가하였다 이러한 혈류유동의 변화는 혈전의 형성 및 내막거식증대가 일어나기 쉬운 혈류역학적 환경을 제공한다. 따라서 스텐트의 삽입으로 인한 동맥류 내부의 혈류 유동은 혈전의 형성 및 동맥류 폐색을 촉진하도록 변화함을 알 수 있었다..

• Clinical and Experimental Pediatrics
• /
• 제49권12호
• /
• pp.1363-1366
• /
• 2006

신생아에서 흉강내 대동맥류는 드물며, 말판 증후군, 대동맥 축착, 대동맥 판막 협착, 동맥염, 터너 증후군, 결절성 경화증 등과 연관되어 보고된 바 있다. 신생아에서 발견되는 ductus arteriosus aneurysm은 매우 드문 질환이나, 대동맥 파열이 유발 될 수 있는 기형이다. 병인으로 대동맥 쪽에 있는 동맥관의 폐쇄 지연, 선천적으로 동맥관 벽이 약한 경우, 자궁내에서 동맥관으로 혈류 증가, 자궁내에서 동맥관의 협착 등이 있으나 명확하지 않은 상태이다. Ductus arteriosus aneurysm은 흉부 방사선, 심초음파, 3차원 전산화단층촬영, 자기 공명영상 검사 등으로 진단할 수 있다. 치료는 인도메사신의 투여, 수술적 절재 등의 방법이 있으며, 자연 소실되는 경우도 있다. 저자들은 태변흡인증후군 환아에서 우연히 발견된 ductus arteriosus aneurysm이 생후 4주 뒤 자연 소실되는 1례를 경험하였기에 보고하는 바이다.

• Journal of Korean Neurosurgical Society
• /
• 제38권2호
• /
• pp.141-143
• /
• 2005

We report a case of pseudoaneurysm formation after aneurysmal clipping. An aneurysm, which was located on the beginning of orbitofrontal artery, was clipped and wrapped with $Surgicel^{(R)}$ and fibrin glue. Four weeks later, an enlarged aneurysm was detected at the same site on postoperative angiography. We could not find a new aneurysm in the second operation except inflated wrapping region. And clip had been slipped from the original aneurysmal neck. So we concluded that a new aneurysm was a pseudoaneurysm made with surgicel and fibrin glue. And it had been formed from continuous minor leakage caused by slipped clip.

• Journal of Cerebrovascular and Endovascular Neurosurgery
• /
• 제25권1호
• /
• pp.75-80
• /
• 2023

The prevalence of aneurysm formation in adults with Moyamoya disease (MMD) is higher than that in the general population. The treatment strategy is often individualized based on the patient's disease characteristics. A 22-year-old man was diagnosed with MMD after presenting a small thalamic intracerebral and subarachnoid hemorrhage in the quadrigeminal cistern. Cerebral angiography revealed a small aneurysm (2.42 mm) in the left anterior choroidal artery. Since the hemodynamics in the left hemisphere was compromised, an indirect bypass surgery was performed. The patient's condition deteriorated postoperatively because of poor perfusion of the internal carotid artery, and massive hydration was required. During neurocritical care, the aneurysm increased in size (5.33 mm). An observation strategy was adopted because of the distal aneurysmal location and the high risk involved. Subsequently, the patient recovered, and newly developed collateral flow appeared from the external carotid artery. Additionally, a dramatic size reduction of the aneurysm (1.51 mm) was noticed. Our case suggests that MMD-related dissecting aneurysms on a distal cerebral artery, which present a high risk of embolization, could be managed by indirectly reducing the hemodynamic burden. Massive hydration in such cases should be avoided or balanced to avoid the risk of rapid growth and aneurysm rupture.

• 대한의용생체공학회:의공학회지
• /
• 제23권5호
• /
• pp.375-383
• /
• 2002

코일을 이용한 동맥류 색전술은 동맥류 내부에 코일을 삽입하여 혈류 유동의 정체를 유도하여 혈전을 형성시키므로 동맥류를 폐색하는 방법이다. 코일을 이용하여 동맥류를 부분 폐색할 경우 동맥류의 폐색 위치에 따라 동맥류 내부의 유동 특성이 변하며, 이는 동맥류 내부의 현전 형성에 영향을 미칠 수 있다. 본 연구에서는 내경 동맥에서 발생한 측방 동맥류에 코일로 인한 부분 폐색이 발생할 경우, 부분 폐색 위치 및 내경 동맥의 곡률 반경의 변화에 따른 동맥류 내부 혈류 유동의 변화를 생체외 모델 실험을 이용하여 측정하여, 효율적인 동맥류 폐색 위치를 제시하고자한다. 내경동맥에서 발생한 측방 동맥류 내부에 코일을 동맥류 천정 근위부, 천정 원위부, 목 근위부 및 목 원위부에 각각 삽입하여 폐색 위치가 다른 모델을 제작하여, 입자영상속도계를 이용하여 속도장을 측정하였다. 동맥류 주머니의 원위부 폐색은 근위부 폐색에 비해 동맥류 내부고의 유입되는 유동이 적었으므로 동맥류 원위부 폐색이 혈전의 형성 및 동맥류 색전에 효율적임을 나타냈다. 동맥류 목 원위부 폐색은 천정 원위부 폐색에 비해 동맥류 내부로 혈류 유입을 효율적으로 차단하였으므로, 목 원위부 폐색이 동맥류 색전에 가장 효율적인 위치임을 알 수 있었다.

• 한국전산유체공학회:학술대회논문집
• /
• 한국전산유체공학회 2008년도 춘계학술대회논문집
• /
• pp.10-12
• /
• 2008

Hemodynamic features of blood flow in the abdominal aorta aneurysm (AAA) are very important, because they are closely related with the rupture of aneurysm to death. It has been considered that the wall shear stress of blood flows influences the formation, growth, and rupture of AAA. On this account, it is important to understand the flow structure of blood in the aneurysm. In this study, the whole velocity field information inside a typical AAA was measured using an in vitro AAA model under the pulsatile flow condition. The vessel geometry was reconstructed based on the computerized tomography (CT) data of a patient. The AAA model was made by using a rapid prototyping (RP) method, based on the reconstructed vessel geometry. Velocity fields in the AAA model were measured at different pulsatile phases using a PIV (particle image velocimetry) system. As experimental results, a large-scale vortex is formed inside the AAA model and the vortices located near the AAA wall are supposed to increase the local pressure and wall shear stress. In this study, the AAA wall stress found to be was one of the most important governing parameters giving rise to the ruptured aneurysm.

• Journal of Chest Surgery
• /
• 제44권5호
• /
• pp.364-367
• /
• 2011

True aneurysm of the brachial artery is a rare disease entity. The mechanism of aneurysm formation is considered to be compression of the arterial wall, producing contusion of the media and subsequent weakness of the wall and fusiform dilatation. It can be caused by arteriosclerotic, congenital, and metabolic disorders, and can be associated with diseases such as Kawasaki's disease. Doppler ultrasonography, computed tomography, arteriography, and selective upper extremity angiography may be performed for establishing the diagnosis of aneurysm. The best therapeutic option is operative repair, and it should be performed without any delay, in order to prevent upper extremity ischemic or thrombotic sequelae. Here, we report a case of recurrent brachial artery aneurysm with review of the literature.

• Journal of Yeungnam Medical Science
• /
• 제14권1호
• /
• pp.237-244
• /
• 1997

A 14-year old boy was admitted with stuporous mentality. CT scan, MRI and cerebral angiogram revealed SAH and a giant aneurysm of right middle cerebral artery($4{\times}5{\times}5.3cm$). To minimize surgical risk, endovascular treatment was done with MDS(mechanical detachable system)-spiral coil. Follow up MRI showed intraluminal thrombus formation of the aneurysm.

• Journal of Chest Surgery
• /
• 제26권12호
• /
• pp.955-958
• /
• 1993

Pseudocoarctation is extremely rare and is due to elongation and kinking of aortic arch which mimiks true coarctation but has no pressure gradient across it. This state is essentially benign entity and needs no surgical intervention, but it frequently tends to progress into the aortic aneurysm that results in compressive symptom due to mass effect and unawared rupture and death.We experienced a descending aortic aneurysm secondary to pseudocoarctation. The patient was 53 year-old female presented as easy f`atiguability and facial flushing. The aortogram revealed tortuous and enlarged aorta at the level of ligamentum arteriosum. The aneurysm was resected and was end-to-end anastomosed successfully under partial cardiopulmonary bypass. The postoperative course was uneventful and the patient was discharged on postoperative 10 day.

• Journal of Korean Neurosurgical Society
• /
• 제65권4호
• /
• pp.531-538
• /
• 2022

Objective : Anterior communicating artery (Acom) aneurysm is one of the most common intracranial aneurysms, constituting approximately 30-35% of all aneurysm formation in the brain. Anatomically, the H-complex (the anatomic morphology of both A1 to A2 segments) is thought to affects the nature of the Acom aneurysm due to its close relationship with the hemodynamics of the vessel. Therefore, we investigated the relative risk factors of aneurysmal rupture, especially focusing on H-complex morphology of the Acom. Methods : From January 2016 to December 2020, a total of 209 patients who underwent surgery, including clipping and coiling for Acom aneurysm in our institution were reviewed. There were 102 cases of ruptured aneurysm and 107 cases of unruptured aneurysm. The baseline morphology of aneurysms was investigated and the relationship between the H-complex and the clinical characteristics of patients with Acom aneurysms was assessed. Results : Of the 209 patients, 109 patients (52.1%) had symmetrical A1, 79 patients (37.8%) had unilateral hypoplastic A1, and 21 patients (10.0%) had aplastic A1. The hypoplastic A1 group and the aplastic A1 group were grouped together as unilateral dominancy of A1, and were compared with the symmetrical A1 group. There was no significant difference in demographic characteristics and radiological findings of Acom aneurysms between two groups. However, when dichotomizing the patients into ruptured cases and unruptured cases, unilateral dominance of the A1 segment was associated with aneurysmal rupture with statistical significance (p=0.011). Conclusion : These results suggest that the unilateral dominance of the A1 segment does not have a significant effect on the morphology of Acom aneurysms, but contributes to aneurysmal rupture. Thus, we can better understand the effects of hemodynamics on Acom aneurysm.