• Title/Summary/Keyword: Aneurysms

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Cerebral Aneurysm in the Long Fenestration at the Middle Portion of M1 Segment

  • Sim, Ki-Bum;Lee, Chang-Sub;Park, Jung-Cheol;Huh, Ji-Soon
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.434-437
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    • 2010
  • We report a unique case of bilateral mirror image M1 aneurysms, one of which was an unruptured aneurysm arising from the proximal end of right middle cerebral artery fenestration with long loop and the other ruptured aneurysm from the contralateral side. We clipped ruptured aneurysm first and unruptured one in three months after the first operation. The difficulties of identifying this unusual vascular anomaly and possible problems during the surgery of an aneurysm at the site of fenestration are discussed with a review of the literature.

Very Late Stent Thrombosis after Sole Stent-Assisted Coiling at the Paraclinoid Giant Aneurysm : Could Prophylactic Antiplatelet Therapy Be Ceased at the Only 1 Year after Procedure?

  • Shin, Jung-Hoon;Park, Seong-Ho;Kim, Chang-Hyun;Lee, Chang-Young
    • Journal of Korean Neurosurgical Society
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    • v.56 no.4
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    • pp.344-347
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    • 2014
  • Stent thrombosis is a major limitation of stent-assisted coiling, which is an effective method for treating wide-necked aneurysms. Although early in-stent thrombosis has been reported, very late stent thrombosis (VLST) (>1 year) has not been reported following implantation of a single self-expandable stent designed for coiling. Herein, the authors present a case of VLST that occurred 14 months after single stent implantation in a large paraclinoid aneurysm with an ultra-wide neck involving the parent artery circumferentially. This case indicates the need for establishing guidelines regarding the optimal duration of prophylactic antiplatelet therapy following stent-assisted coiling, which remains undefined in the neuroendovascular field.

Usefulness of Motor-Evoked Potentials Monitoring for Neurosurgical Treatment of an Unusual Distal Anterior Choroidal Artery Aneurysm

  • Champeaux, Charles;Jecko, Vincent;Eimer, Sandrine;Penchet, Guillaume
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.414-419
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    • 2016
  • A 35 years old woman presented with an acute meningeal syndrome following an intra ventricular haemorrhage without subarachnoid haemorrhage. The angiography demonstrated a 6 mm partially thrombosed saccular aneurysm at the plexal point of the right anterior choroidal artery (AChoA). It was surgically approached inside the ventricle through a trans-temporal corticotomy. The aneurysm was excised after distal exclusion of the feeding artery under motor-evoked potentials monitoring. Of the 19 cases of distal AChoA aneurysm neurosurgical treatment, this is the only one performed under electrophysiology monitoring, a simple and safe method to detect and prevent motor tract ischemia. We discuss this rare case, along with a comprehensible review of the literature of the previous surgical cases of distal AChoA aneurysms.

Thoracic Aortic Aneurysm (흉부 대동맥류)

  • Kim, Su-Hyeon;Lee, Jeong-Cheol;Han, Seung-Se
    • Journal of Chest Surgery
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    • v.25 no.8
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    • pp.877-884
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    • 1992
  • From October, 1986, to June, 1992 16 patients, 13 male and 3 female patients ranging in age 28 to 70 years, were operated on for thoracic aortic aneurysm, The etiology of these patients was atherosclerotic in 10, cystic medial necrosis in 4, and trauma in 2 cases, All patients were treated by use of CPB and circulatory arrest was applicated in one patient, Ten patients had aneurysms involving ascending aorta and six patients had descending aortic aneurysm, Among ten patients with ascending aortic aneurysm, annuloaortic ectasia with aortic regurgitation were seven and all underwent surgery with composite technique [Bentall operation], The other six patients with descending thoracic aneurysm were performed graft replacement. There was no early mortality but two late deaths occurred due to cerebral hemorrhage and renal problems at POD 3mo and 39mo respectively, We obtained satisfactory long-term results and overall survival rate at 5 year was 74.7%.

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Retroperitoneal Approach for the Surgical Treatment of Abdominal Aortic Aneurysm; One Case Report (복막후방접근방법을 이용한 상복부 대동맥류의 외과적 치료;1례 보고)

  • 홍순필
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.492-495
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    • 1993
  • We experienced one case of surgical treatment of abdominal aortic aneurysm using retroperitoneal approach. The transperitoneal route has been the standard surgical approach for elective and emergency treatment of aneurysmal or occlusive disease. Among its cited advantages for aortic reconstruction are familarity with the exposure, easy access to the infrarenal aorta and iliac vessels, possibility of simultaneous inspection of the intra-abdominal viscera, and speed of opening and closure.Despite the proved versatility of the transperitoneal approach, it is commonly associated with prolonged ileus, increased third space fluid loss, and significant pulmonary complications. The retroperitoneal approach, on the other hand, has many advantages; excellent exposure for the repair of juxtarenal or suprarenal abdominal aortic aneurysms and visceral vessel occlusive disease, fewer postoperative complications, decreased postoperative third-space fluid losses from intraoperative evaporation and ileus, and improved postoperative pulmonary function. Atherosclerosis was most common cause of abdominal aortic aneurysm. Dacron graft[18mm] was replaced successfully.Postoperative course was uneventful and he was discharged in good condition.

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Aortobronchial Fistula After Chest Trauma (흉부수상후에 발생한 대동맥기관지루)

  • 김재현;문상호;김삼현;서필원;임수빈;박성식
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.141-143
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    • 2002
  • Few patients with traumatic aortic laceration remain undiagnosed and survive long enough to develop a chronic aneurysm. Such aneurysms are frequently asymptomatic: alternatively, they may manifest chest pain, dysphagia, bronchial irritation, or sudden death. A case of aortobronchial fistula secondary to a chronic post-traumatic aneurysm of the aortic isthmus is presented. Hemoptysis was the main sign. The affected segment of the thoracic aorta was repaired with a Hemashield patch and a left upper lobectomy was performed.

Wrapping of an Ascending Aortic Aneurysm with the Multiple Boot-Straps Technique in a Patient Undergoing Off-Pump Coronary Artery Bypass Grafting

  • Na, Kwon Joong;Kim, Jun Sung;Park, Kay-Hyun;Lim, Cheong
    • Journal of Chest Surgery
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    • v.48 no.3
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    • pp.206-209
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    • 2015
  • Ascending aortic aneurysms are usually treated with graft replacement under cardiopulmonary bypass. However, if a candidate for off-pump coronary artery bypass grafting has an enlarged ascending aorta, surgeons may consider wrapping it without cardiopulmonary bypass. Here, we report a 78-year-old female who underwent successful wrapping of the ascending aorta concomitant with off-pump coronary artery bypass grafting, using a new wrapping technique that involves multiple bootstraps.

Surgical Management of the Chronic Dissecting Aneurysm of Ascending Aorta with Aortic Regurgitation (만성 해리성 대동맥류 환자에서의 Bentall 씨 수술적응진성 및 가성 내강 동시 혈류공급술)

  • 강면식
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.184-190
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    • 1988
  • The treatment of aortic aneurysm of ascending aorta has been fraught with difficult surgical problems. For the most part, these were resolved in 1968 with the introduction of a technique of total replacement of ascending aorta and reimplantation of the coronary arteries by Bentall and De Bono. This technique however, with all of its advantages, caries a certain problems. In chronic dissecting aneurysms, there is frequently a marked disparity in circumference between the true and false lumen distally. Distal perfusion is directed into both the true and false lumens by removing segment of the septum between the two lumens and constructing the distal graft anastomosis is to the outer layer of aortic adventitia. The distal false lumen, aortic branches and fenestrations have matured and healed in most cases. And importantly, major aortic tributaries may be solely dependent on the false lumen for perfusion. We are presenting two cases of chronic dissecting aneurysm of ascending aorta with aortic regurgitation, who have good result by surgical correction of so-called Bentall procedure with maintenance of blood flow directed into both true and false lumen.

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Surgical Management of Giant Aneurysm of Intracranial Artery Under Circulatory Arrest -one case report- (총순환정지를 이용한 두개강내 거대동맥류 치험 1례)

  • 홍종면;김오곤;이석재;홍장수;민경수;김상태;임승운;송우익
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.80-83
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    • 1999
  • Complete circulatory arrest with profound hypothermia has been an indispensable adjunct to the safe management of selected giant intracranial aneurysms. For the conduct of cardiopulmonary bypass, there are usually two kinds of methods, open and closed chest methods. We could manage one case of huge intracranial aneurysm that was successfully operated under circulatory arrest using the closed chest method, especially with percutaneous insertion of arterial and venous cannulas for cardiopulmonary bypass.

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Two Cases of Recurrent Laryngeal Nerve Palsy Related to Aortic Aneurysm (대동맥류로 인한 좌측 반회후두신경마비 2례)

  • 최홍식;강성석;문상우;김명상
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.8 no.2
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    • pp.232-234
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    • 1997
  • After the first report of mitral stenosis as a cause of recurrent laryngeal nerve palsy by Ortner in 1897, many authors have described that some kinds of cardiovascular disease might contribute to the development of recurrent laryngeal nerve palsy. The estimated rate of aortic aneurysm related with recurrent laryngeal nerve palsy is about 5%. Aortic aneurysm is classified into 3 types according to the involving segment of aorta in which aneurysms develop, and the first class-aneurysm in ascending aorta and aortic arch-is known to be the only type related to recurrent laryngeal nerve palsy. Recently we experienced two cases of recurrent laryngeal nerve palsy each of which had aneurysm on aortic arch as a major contributing factor. We report these cases with brief review of the literature.

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