Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
권호 표지

Analysis of Incomplete Occlusion of Cerebral Aneurysm by Intraoperative Indocyanine Green Videoangiography

수술중 인도시아닌 비디오 혈관조영술에 의한 뇌동맥류의 불완전 폐쇄의 분석

  • Lee, Jae-Chul (Department of Neurosurgery, Neurosceince Center, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Jang, Kyung-Sool (Department of Neurosurgery, Neurosceince Center, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Jang, Dong-Kyu (Department of Neurosurgery, Neurosceince Center, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Han, Young-Min (Department of Neurosurgery, Neurosceince Center, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Park, Sang-Kyu (Department of Neurosurgery, Neurosceince Center, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Yun, Wan-Soo (Department of Neurosurgery, Neurosceince Center, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Kim, Jong-Tae (Department of Neurosurgery, Neurosceince Center, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Chung, Dong-Sup (Department of Neurosurgery, Neurosceince Center, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Park, Young-Sup (Department of Neurosurgery, Neurosceince Center, Incheon St. Mary's Hospital, The Catholic University of Korea)
  • 이재철 (가톨릭대학교 의과대학 인천성모병원 신경외과학교실) ;
  • 장경술 (가톨릭대학교 의과대학 인천성모병원 신경외과학교실) ;
  • 장동규 (가톨릭대학교 의과대학 인천성모병원 신경외과학교실) ;
  • 한영민 (가톨릭대학교 의과대학 인천성모병원 신경외과학교실) ;
  • 박상규 (가톨릭대학교 의과대학 인천성모병원 신경외과학교실) ;
  • 윤완수 (가톨릭대학교 의과대학 인천성모병원 신경외과학교실) ;
  • 김종태 (가톨릭대학교 의과대학 인천성모병원 신경외과학교실) ;
  • 정동섭 (가톨릭대학교 의과대학 인천성모병원 신경외과학교실) ;
  • 박영섭 (가톨릭대학교 의과대학 인천성모병원 신경외과학교실)
  • Published : 2010.09.30
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Abstract

Objective : This study aimed to investigate factors associated with incomplete occlusion of a cerebral aneurysm detected by indocyanine green videonangiography (ICG-VA) following aneurysm clipping. Methods : We performed surgery on 135 patients with 151 intracranial aneurysms over a 1-year period. Included was an aneurysm more than 3 mm in size, the dome of which was sufficiently exposed and clipped permanently with one clip. Following ICG-VA, aneurysms were divided into a delayed-filling group and a no-filling group. Retrospective comparisons of the clip force, blade length and width, neck and dome size of the aneurysm, diameter of the parent artery, presence of atherosclerosis in the aneurysm neck, and systolic blood pressure during ICG-VA were made between the two groups. Results : Eight of 31 aneurysms in 29 patients showed delayed filling of contrast. The clip force in the delayed-filling group was lower than in the no-filling group and the atherosclerosis of the aneurysm neck differed between the two groups (P<0.05). Blade width in the delayed-filling group was also significantly lower than in the no-filling group (P<0.05). Following adjustment for atherosclerosis of the aneurysm neck, clip force and blade width in the delayed-filling group was even lower. Incomplete passage of the clip tip was observed in four aneurysms, weak clip force in three, and a slit between clip blades in one. After booster clipping or clip reposition, neither aneurysm regrowth nor recanalization was observed during 6 months of follow-up. Conclusion : Closing force, blade width, tip position, and remnant slit are important for incomplete occlusion of an aneurysm.

Keywords

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