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대 뇌동맥류 및 거대 뇌동맥류의 수술적 가료

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Author(s)
임만빈이창영김일만손은익김동원Man-Bin YimChang-Young LeeIll-Man KimEun-Ik SonDong-Won Kim
Keimyung Author(s)
Yim, Man BinLee, Chang YoungKim, ElSon, Eun IkKim, Dong Won
Department
Dept. of Neurosurgery (신경외과학)
Brain Research Institute (뇌연구소)
Journal Title
대한신경외과학회지
Issued Date
2001
Volume
30
Issue
6
Abstract
Objectives:The goal of the surgical management of large and giant aneurysm is complete extirpation of the aneurysms with preservation or reconstruction of the parent artery. To improve the surgical management results of those aneurysms in the future, we review our experience and discuss technical maneuvers and strategies used to avoid potential complications of those aneurysm surgery.
Material and Methods:During the past 12 years, thirty six cases of large and giant aneurysms(diameter>19mm) were managed by surgery. The clinical characteristics, treatment methods, surgical complications and outcome of those cases were analyzed and, based on the review of the literatures, the preventive methods of surgical complication related to the clipping of those aneurysms were discussed.
Results:The locations of those aneurysms were anterior circulation in 34 cases and posterior circulation in 2 cases. The most frequent site of aneurysmal location was a paraclinoidal region of the anterior circulation. The aneurysms were managed surgically by direct clipping of aneurysmal neck in 31 cases, aneurysmal trapping followed by extracranial-intracranial bypass in 2 cases, proximal clipping of parent artery, aneurysmorrhaphy, and excision of aneurysm followed by end to end anastomosis of parent artery in each one case. Surgical complications occurred in 13 cases. A parent vessel occlusion by thrombus formation and parent vessel stenosis after clipping of aneurysm were the main complications. We obtained good outcome in 27, fair 5, poor 1 and dead in 3 case(s).
Conclusion:We conclude that selection of suitable management method for each case, high quality of surgical technique and prevention of complication during operation are important key points for the successful treatment of large and giant aneurysm. The heparinization prior to application of temporary clip on parent vessels, aneurysmal decompression during dissection and clipping of aneurysm, complete closing of the aneurysmal neck and avoiding the narrowing of parent vessel after clipping of aneurysm were the main technical maneuvers used to avoid complications of those aneurysm surgery.
Alternative Title
Surgical Management of Large and Giant Aneurysm
Keimyung Author(s)(Kor)
임만빈
이창영
김엘
손은익
김동원
Publisher
School of Medicine
Citation
임만빈 et al. (2001). 대 뇌동맥류 및 거대 뇌동맥류의 수술적 가료. 대한신경외과학회지, 30(6), 805–812.
Type
Article
ISSN
1225-8245
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/39171
Appears in Collections:
3. Research Institutues (연구소) > Brain Research Institute (뇌연구소)
1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
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