• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2002년도 춘계학술대회 논문집
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• pp.124-127
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• 2002

Ceil embolisation technique has been used to treat the intracranial aneurysms. Microcoils inserted into the aneurysm sac induce the blood flow stagnation inside the aneurysm sac, which causes the thrombus formation and embolisation of aneurysm. Since the intraaneurysmal flow patterns affect the embolisation process, we want to measure the flow field for different locations of coil inside the aneurysm sac . Lateral aneurysm models are manufactured using rapid prototyping, and the velocity fields are measured using particle image velocitimeter. Distally blocked models showed less flow into the aneurysm sac comparing to proximally blocked models. Also blocking the neck of aneurysm showed better inflow blocking comparing to blocking the dome of aneurysm. These results suggest that distal neck should be the preferred locations of coil for aneurysm embolisation.

• International Journal of Precision Engineering and Manufacturing
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• 제5권1호
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• pp.42-46
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• 2004

Aneurysm embolization method using coils has been widely used. When partial blocking of an aneurysm is inevitable, the locations of coils are important since they change the flow patterns inside the aneurysm, which affect the embolization process. We calculated the flow fields inside the partially blocked lateral aneurysm models for different coil locations-proximal neck, distal neck, proximal dome and distal dome. Flow into the aneurysm sac was significantly reduced in the distally blocked models, and coils at the distal neck blocked inflow more effectively comparing to those at the distal dome. This study suggests that the distal neck should be the most effective location for aneurysm embolization.

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

• Journal of Korean Neurosurgical Society
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• 제55권6호
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• pp.357-361
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• 2014

Computed tomography angiography (CTA) is commonly used in setting of subarachnoid hemorrhage, but imaging features of aneurysm rupturing taking place at the time of scanning has rarely been described. The author reports a case of actively rebleeding aneurysm of the anterior communicating artery with intraventricular extravasation on the hyperacute CTA imaging. The rebleeding route, not into the third ventricle but into the lateral ventricles, can be visualized by real-time three-dimensional CT pictures. The hemorrhage broke the septum pellucidum and the lamina rostralis rather than the lamina terminalis.

• Journal of Chest Surgery
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• 제6권1호
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• pp.51-56
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• 1973

This is one case report of successful resection of the aneurysm of the thoracic aorta, which det-ected by thoractomy unexpectedly, in the Department of Thoracic Surgery, Hanyang University Hospital. The patient was a 34 years old woman and subjective complaints was not related with the aneurysm. Chest film showed a small round hazy shadow in the left margin of the upper posterior mediastinum. A saccular aneurysm located on the descending thoracic aorta, 7cm distal to the left subclavian artery and arouse from the antero-lateral wall of the aorta. Excision of the saccular aneurysm was performed by cross clamping the descending aorta above and below the aneurysm, and then the defect of the aortic wall was closed by aortorrhaphy with continuous suture. Crossclamping time was required 15 minute. Histopathologically, the wall of the aneurysm consisted of all layers of the arterial wall, that is, intima, media and adventitia. Postoperative course was uneventful and aortogram showed good continuity of the blood flow of the entire aorta.

• Journal of Chest Surgery
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• 제22권6호
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• pp.1078-1083
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• 1989

We experienced one case of the left ventricular aneurysm. The patient was 44 years old male, who complained of dysarthria and dysphagia due to right cerebellar infarction EKG revealed antero-lateral myocardial infarction, so checked 2-D echo-cardiogram showed the left ventricular aneurysm with the mural thrombus. Aneurysmectomy with removal of thrombi was made for preventing further propagation of the systemic embolization. But CABG was impossible due to fine coronary artery at the portion of myocardial infarction. Mild LCOS was noted but postop course was smooth. During 12 months follow-up period, he lives in good physical activity [MYHA F.C. II /IV] and absence of chest pain.

• Journal of Korean Neurosurgical Society
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• 제40권6호
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• pp.455-458
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• 2006

The incidence of blindness after aneurysm surgery is very rare. We experienced a case of unilateral blindness after internal carotid artery[ICA] aneurysm wrapping. A 43-year-old male immediately developed ipsilateral ocular pain and visual loss in his left eye after the treatment of a lateral ICA aneurysm by wrapping with muscle pieces. He had also multiple aneurysms, which were multilobulated anterior communicating artery [A-com], middle cerebral artery[MCA] and posterior communicating artery [P-com] aneurysms. Coilings were done for a part of A-com artery aneurysm and P-com artery aneurysm on admission. The remaining A-com artery aneurysm was clipped and ICA aneurysm was wrapped with temporal muscle piece. A retrobulbar optic neuropathy might have resulted from either direct injury or damage to small dural vessels of the posterior optic nerve. Actually, the optico-carotid space was tight and the optic nerve was compressed by swollen muscle piece. Despite releasing of compression of the optic nerve on second day, his visual loss was irreversible.

• Journal of Korean Neurosurgical Society
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• 제51권3호
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• pp.160-163
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• 2012

We report an unusual case of lateral medullary infarction after successful embolization of the vertebral artery dissecting aneurysm (VADA). A 49-year-old man who had no noteworthy previous medical history was admitted to our hospital with a severe headache. Computed tomography (CT) revealed a subarachnoid hemorrhage, located in the basal cistern and posterior fossa. Cerebral angiography showed a VADA, that did not involve the origin of the posterior inferior cerebellar artery (PICA). We treated this aneurysm via endovascular trapping of the vertebral artery distal to the PICA. After operation, CT revealed post-hemorrhagic hydrocephalus, which we resolved with a permanent ventriculoperitoneal shunt procedure. Postoperatively, the patient experienced transient mild hoarsness and dysphagia. Magnetic resonance image (MRI) showed a small infarction in the right side of the medulla. The patient recovered well, though he still had some residual symptom of dysphagia at discharge. Such an event is uncommon but can be a major clinical concern. Further investigation to reveal risk factors and/or causative mechanisms for the medullary infarction after successful endovascular trapping of the VADA are sorely needed, to minimize such a complication.

• Journal of Korean Neurosurgical Society
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• 제37권6호
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• pp.399-404
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• 2005

Objective: Aneurysms arising from the posterior inferior cerebellar artery(PICA) are uncommon. We review literature on that and surgical results on aneurysmal treatment by choice of surgical approach. Methods: On the basis of radiologic findings & charts, we review retrospectively the surgical results of 12 cases from Mar 1999 to Dec 2003. Results: The mean age of the 12 patients was 55.8(ranged from 36 to 71) and female was predominant (female:male = 8:4). Locations of PICA aneurysms revealed variously(vertebral artery - PICA junction: 8, lateral medullary segment: 2, PICA - anterior inferior cerebellar artery common trunk: 1, telovelomedullary : 1). Surgical approaches & treatments were attempted in 11 cases and embolization was done in 1 case(Far lateral transcondylar or supracondylar approach & clipping: 9, Far lateral transcondylar or supracondylar approach and trapping: 2, suboccipital approach & clipping: 1). The surgical result were 8 of 12 patients were good outcome, 1 of 12 was severely disabled and 3 of 12 were died. Conclusion: First, we choose surgical approach by the laterality of aneurysms and surgical or interventional treatment is attempted as soon as possible. The PICA aneurysm is regarded as having a relatively good surgical outcome without drilling of the posterior arch of the atlas.

• 대한의용생체공학회:의공학회지
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• 제25권4호
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• pp.295-300
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• 2004

코일을 동맥류에 삽입하여 동맥류 내부 유동 정체를 유발하므로 동맥류를 치료 방법이 최근 많이 사용되고있다. 동맥류의 내부를 코일로 완전히 채우지 못하고 부분 폐색할 경우가 발생하며, 동맥류의 부분 폐색 위치에 따라 혈류 유동이 변하므로 이는 동맥류 내부의 혈전 형성에 영향을 미필 수 있다. 또한 동맥류가 발생한 모혈관의 형상에 따라 동맥류로 유입되는 유동 특성이 변하므로, 모혈관의 형상에 따라 효율적인 동맥류 폐색을 위한 코일의 위치가 변할 수 있다. 효율적인 동맥류 폐색을 위한 코일 위치를 제시하기 위하여 내경 동맥에서 발생한 측방 동맥류의 부분 폐색위치와 내경 동맥의 형상에 따른 동맥류 내부 유동장을 수치해석을 이용하여 해석하였다. 3차원 맥동 유동장은 혈액의 비뉴톤성 점성 특성을 고려하여 계산되었다. 또한 동맥류 폐색에 영향을 미치는 유체역학적 인자인 동맥류 유입 유량 및 벽전단응력을 계산하였다. 코일은 동맥류 목에 삽입하였을 경우에는 천정부에 삽입한 경우에 비해 동맥류 내부로 혈류의 유입을 감소되었다. 임계 벽전단응력 이하의 저 전단응력지역은 곡선형 모혈관에 비해 직선형 모혈관에서 컸으며, 원위부 목 폐색 모델에서 가장 크게 나타났다. 따라서 동맥류 원위부 목은 동맥류 내부로의 혈류 유입이 감소하고, 저 전단응력 지역을 크게하는 코일 위치이므로, 이 위치는 동맥류 색전술시 혈전의 형성으로 인한 동맥류 폐색에 적합한 위치로 예상된다.