• Title/Summary/Keyword: Aneurysm rupture

검색결과 225건 처리시간 0.257초

Surgical Treatment of the Abdominal Aortic Aneurysm (복부 대동맥류의 외과적 치료)

  • 황석하
    • Journal of Chest Surgery
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    • 제26권5호
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    • pp.355-359
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    • 1993
  • Ten consecutive patients with abdominal aortic aneurysm were treated in Chungnam National University Hospital from May of 1985 to June of 1993. Pulsating palable mass was the most common first sign [7 patients]. The ratio of male to female was 8:2. The age ranged from 53 to 73 years with mean age of 65 years. The etiology and location of the aneurysm was atherosclerosis and infrarenal aorta in all. Dacron graft interposition [straight graft-1, bifurcation graft-7] and wrapping with aneurysmal sac were performed in 8 patients. In one patient with infected abdominal aortic aneurysm, we performed aneurysmectomy and left axillo-bifemoral bypass with 8 mm PTFE graft. And in another patient with complete thrombotic obstruction of infrarenal aortic aneurysm, we performed the suturing of the proximal part of the abdominal aortic aneurysm and aorto-bifemoral bypass with 18 x 9 mm PTFE graft. There was one operative death with the mortality rate of 11 % and 8 complications in 4 patients; ARF[2], duodenal ulcer[1], mechanical ileus[1], genitourinary dysfunction[2] and wound infection with abdominal abscess[1]. Because of the high operative mortality after rupture of the aneurysm, we think it is better to operate on early at the diagnosis of abodominal aortic aneurysm is made.

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Immunohistochemical Study for the Angiogenesis Factors and Vascular Wall Matrix Proteins in Intracranial Aneurysms (뇌동맥류에서 혈관형성 인자와 혈관벽 기질 단백에 대한 면역조직화학적 연구)

  • Kim, Jae Hong;Yim, Man Bin;Lee, Chang Young;Kim, Sang Pyo
    • Journal of Korean Neurosurgical Society
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    • 제29권12호
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    • pp.1584-1591
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    • 2000
  • Objective : Until now, it has been little known about the biological mechanisms associated with the genesis, growth, and rupture of intracranial aneurysm. This study was performed to investigate and understand a part of these mechanisms. Materials and Methods : Immunohistochemical stains for angiogenesis growth factors(basic fibroblast growth factor (bFGF) and vascular endothelial growth factor(VEGF)) and selected vascular wall matrix proteins(alpha smooth muscle actin(${\alpha}SMA$) and collagen Type IV) were performed in fixed sections from a normal circle of Willis artery which was taken from the autopsy specimen as a control vessel and 17 aneurysmal wall specimens which was taken during surgical clipping of aneurysms. The staining intensity and distribution of immunoreactivity to angiogenesis growth factors and selected wall matrix proteins in control vessel and aneurysmal wall were examined and compared with each other. The difference of staining intensity according to the size of aneurysm was also investigated. Results : There was no immunoreactivity to bFGF and VEGF in the control vessel. bFGF immunoreactivity was exhibited in 15 of 17 aneurysm specimens around smooth muscle cells within the media of aneurysm. VEGF immunoreactivity was also exhibited in all aneurysm specimens in patches or diffusely affecting all layers of the aneurysmal wall. The degrees of intensity of bFGF and VEGF immunoexpression were proportionate roughly to the size of aneurysm. Strong immunoexpression of both factors were noticed in large aneurysm. A regularly arranged and defined band of immunoreactivity of ${\alpha}SMA$ was noticed in the media of the control vessel, whereas diffuse, faint, irregularly arranged ${\alpha}SMA$ was noticed in the aneurysmal wall. A regularly defined band of collagen Type IV immunoreactivity was also noticed in the subendothelium of the control vessel, whereas diffuse disorganized immunoreactivity of collagen Type IV was noticed in the entire wall of the aneurysm. Conclusion : These results indicate substantial evidences of abnormal expression of angiogenesis factors and changes of selected vascular wall matrix proteins in the wall of intracranial aneurysm. The unbalanced changes of angiogenesis factors and vascular wall matrix proteins in the wall of aneurysm may be one of the biological mechanisms for the growth and rupture of aneurysm.

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Recurrent Subarachnoid Hemorrhage after Complete Obliteration of Intracranial Aneurysm

  • Yang, Tae-Ki;Kim, Chul-Jin
    • Journal of Korean Neurosurgical Society
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    • 제46권5호
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    • pp.492-494
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    • 2009
  • The authors report a case of recurrent subarachnoid hemorrhage (SAH) after complete occlusion of an intracranial aneurysm. It is known that regrowth of an aneurysm after the complete clipping is a rare event. For detection of recurrence, however, it may be necessary to follow up with the patient regularly after the initial operation for intracranial aneurysms, because re-rupture of an aneurysm can cause a fatal result, and the cumulative risk of a recurrent SAH is thought to be not low over time.

Spontaneous Hemomediastinum and Hemothorax Caused by a Ruptured Bronchial Artery Aneurysm

  • Seo, Yeon-Ho;Kwak, Jin-Young
    • Journal of Chest Surgery
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    • 제44권4호
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    • pp.314-317
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    • 2011
  • A bronchial artery aneurysm (BAA) is uncommon and usually associated with chronic inflammatory lung disease or a systemic vascular condition, which is rarely the etiology of mediastinal hemorrhage. A middle-aged person presented with spontaneous hemothorax and hemomediastinum. A diagnostic evaluation identified a bronchial artery aneurysm as the source. To prevent further rupture, we performed a bronchial artery embolization. In the absence of trauma or other causes for hemothorax and mediastinal hemorrhage, the possibility of a BAA should be considered. A bronchial artery aneurysm can be managed by interventional techniques as well as surgery.

Iatrogenic Subclavian Artery Aneurysm: Report of a Case (의인성 쇄골하 동맥류 수술 치험 1례)

  • 오중환;박승일;원준호
    • Journal of Chest Surgery
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    • 제32권8호
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    • pp.753-756
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    • 1999
  • Iatrogenic suclavian artery aneurysm is a rare disease which requires surgery because of the dangers of a rupture. We report a case of an aneurysm of the right subclavian artery developed by an iatrogenic trauma in a 43-year-old male. The preoperative diagnosis was made by an angiography and Doppler ultrasonogram. After the resection of a 6${\times}$7 cm sized aneurysm, an end to end anastomosis was done with a 6 mm Gore-Tex vascular graft. The post-operative course was uneventful and has been followed up from 3 months after discharge.

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Strategy for the Patient with Tuberculum Sellae Meningioma Combining Bilateral Internal Artery Aneurysm

  • Cha, Ki-Yong;Park, Sang-Keun;Hwang, Yong-Soon;Kim, Tae-Hong
    • Journal of Korean Neurosurgical Society
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    • 제38권2호
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    • pp.151-154
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    • 2005
  • A 43-year-old woman was admitted with the chief complaint of progressive visual disturbance and her brain radiological studies disclosed well demarcated tumor at tuberculum sellae area and bilateral mirror image paraclinoid internal carotid artery saccular aneurysms. A larger left side aneurysm was pointing medialy and almost encased by the tumor. Although a brain tumor and intracranial aneurysm can be simultaneously treated by surgery, the high risk of intra-operative aneurysm rupture should be considered. Therefore, the author secondly performed tumor resection after the endovascular embolization of the aneurysm which was embedding the tumor using a Guglielmi detachable coil. After successful treatment of the patient with tuberculum sellae meningioma associated with bilateral mirror image paraclinoid aneurysms using endovascular and surgical techniques, the authors present the case with a review of the related literatures.

Solitary Ruptured Aneurysm of the Spinal Artery of Adamkiewicz with Subarachnoid Hemorrhage

  • Son, Seong;Lee, Sang-Gu;Park, Cheol-Wan
    • Journal of Korean Neurosurgical Society
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    • 제54권1호
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    • pp.50-53
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    • 2013
  • Spinal subarachnoid hemorrhage (SAH) due to solitary spinal aneurysm is extremely rare. A 45-year-old female patient visited the emergency department with severe headache and back pain. Imaging studies showed cerebral SAH in parietal lobe and spinal SAH in thoracolumbar level. Spinal angiography revealed a small pearl and string-like aneurysm of the Adamkiewicz artery at the T12 level. One month after onset, her back pain aggravated, and follow-up imaging study showed arachnoiditis. Two months after onset, her symptoms improved, and follow-up imaging study showed resolution of SAH. The present case of spinal SAH due to rupture of dissecting aneurysm of the Adamkiewicz artery underwent subsequent spontaneous resolution, indicating that the wait-and-see strategy may provide adequate treatment option.

Acute Subdural Hematoma Associated with Ruptured Intracranial Aneurysm: Diagnosis and Emergent Aneurysm Clipping

  • Kim, Jung-Min;Hur, Jin-Woo;Lee, Jong-Won;Kim, Myoung-Soo
    • Journal of Korean Neurosurgical Society
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    • 제37권5호
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    • pp.375-379
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    • 2005
  • Rarely, rupture of a cerebral aneurysm causes an acute subdural hematoma(SDH) in addition to subarachnoid hemorrhage(SAH). We report clinical and radiological characteristics of five cases, as well as potential pitfalls in the diagnosis and the treatment of this life-threatening condition. The patients ranged in age from 42 to 76 years. The Hunt-Hess grade on admission was grade III in one patient, grade IV in two, and grade V in two. All five patients un-derwent one-stage operation (both SDH evacuation and clipping of the aneurysm). The outcome was good recovery in two patients, persistent vegetative state in two, and death in one. Patients with a good outcome had a better Hunt-Hess grade on admission, with less amount of SDH.

Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm: A Comprehensive Review

  • Hyoung Ook Kim;Nam Yeol Yim;Jae Kyu Kim;Yang Jun Kang;Byung Chan Lee
    • Korean Journal of Radiology
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    • 제20권8호
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    • pp.1247-1265
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    • 2019
  • Abdominal aortic aneurysm (AAA) can be defined as an abnormal, progressive dilatation of the abdominal aorta, carrying a substantial risk for fatal aneurysmal rupture. Endovascular aneurysmal repair (EVAR) for AAA is a minimally invasive endovascular procedure that involves the placement of a bifurcated or tubular stent-graft over the AAA to exclude the aneurysm from arterial circulation. In contrast to open surgical repair, EVAR only requires a stab incision, shorter procedure time, and early recovery. Although EVAR seems to be an attractive solution with many advantages for AAA repair, there are detailed requirements and many important aspects should be understood before the procedure. In this comprehensive review, fundamental information regarding AAA and EVAR is presented.

Pathologic change of an arterialized giant venous aneurysm of a brachiocephalic arteriovenous fistula

  • Su Wan Kim;Jonggeun Lee;Seogjae Lee;Jee Won Chang;Chang Lim Hyun
    • Journal of Medicine and Life Science
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    • 제20권4호
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    • pp.178-182
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    • 2023
  • Aneurysmal venous dilatation is a frequent complication of arterio venous fistulas (AVFs) created for hemodialysis. Venous aneurysm rupture can lead to lethal hemorrhage. A 49-year-old male patient presented with a giant aneurysmal dilatation of his AVF 10 years after its creation. The patient had complaints of pulsating pain and discomfort due to swelling of the left forearm. We performed an aneurysm resection and revised the overlying dermal lesion through a brachial plexus block. Here, we describe the pathological features of the arterialized venous aneurysm compared to simple venous aneurysms.