• Journal of Korean Neurosurgical Society
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• 제45권4호
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• pp.236-239
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• 2009

Carotid occlusion is an inevitable therapeutic modality for the treatment of complex aneurysms such as giant, traumatic, and intracavernous aneurysms. Late complications of carotid occlusion include 'de novo' aneurysm formation at a distant site because of hemodynamic changes in the circle of Willis. We report a case of de novo aneurysm in a vessel that appeared to be normal on initial angiography. The patient developed an anterior communicating artery aneurysm and marked growth of a basilar bifurcation aneurysm 9 years after trapping of the left internal carotid artery for the treatment of a ruptured large saccular aneurysm involving ophthalmic and cavernous segments. We propose that patients who undergo therapeutic carotid occlusion should be periodically followed by magnetic resonance angiography or computed tomographic angiography to evaluate the possibility of de novo aneurysm formation; this advice is in line with previous reports.

• Journal of Korean Neurosurgical Society
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• 제56권6호
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• pp.496-499
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• 2014

Owing to the focal wall defect covered with thin fibrous tissues, an aneurysm arising from the dorsal wall of the internal carotid artery (ICA) is difficult to manage either surgically or endovascularly and is often associated with high morbidity and mortality. Unfortunately, the definitive treatment modality of such highly risky aneurysm has not yet been demonstrated. Upon encountering the complex intracranial pathophysiology of such a highly precarious aneurysm, a neurosurgeon would be faced with a challenge to decide on an optimal approach. This is a case of multiple paraclinoid aneurysms including the ICA dorsal wall aneurysm, presented with spontaneous subarachnoid hemorrhage. With respect to treatment, direct clipping with a Sundt graft clip was performed after multiple endovascular interventions had failed. This surgical approach can be a treatment modality for a blood blister-like aneurysm after failed endovascular intervention(s).

• Journal of Chest Surgery
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• 제22권1호
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• pp.90-94
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• 1989

Ten patients underwent operation for aortic aneurysms from Jan. 1983 to April 1988 at the Department of Thoracic and Cardiovascular Surgery, Keimyung University Hospital. There were 7 males and 3 females in this series. The age ranged from 16 to 70 years with the mean age of 45 years. The cause of the aneurysm was atherosclerosis in 8 patients, mycosis in 1 patient and unknown in 1 patient. There were two patients with ascending aortic aneurysm treated by Dacron graft replacement, with no hospital death. One patient with aortic arch aneurysm was received Dacron graft replacement under cardiopulmonary bypass and died on the 21st postoperative day because of cerebral edema. There were three patients with descending aortic aneurysm. The aneurysm in two patients was successfully repaired by Dacron graft. One additional patient with ruptured aneurysm died at operation because of ventricular fibrillation. Four patients with abdominal aortic aneurysm were underwent Dacron graft replacement and the results were good.

• Journal of Korean Neurosurgical Society
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• 제51권1호
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• pp.62-65
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• 2012

Despite the remarkable developments in neurosurgical and neuro-interventional procedures, the optimal treatment for large or giant partially thrombosed aneurysms with a mass effect remains controversial. The authors report a case of a partially thrombosed aneurysm with a mass effect, which was successfully treated by stent-assisted coil embolization. A 41-year-old man presented with headache. Brain computed tomography depicted an $18{\times}18$ mm sized thrombosed aneurysm in the interpeducular cistern. More than 80% of the aneurysm volume was filled with thrombus and the canalized portion beyond its neck measured $6.8{\times}5.6$ mm by diagnostic cerebral angiography. Stent-assisted endovascular coiling was performed on the canalized sac and the aneurysm was completely obliterated. Furthermore, most of the thrombosed aneurysm disappeared in the interpeduncular cistern was clearly visualized follow-up brain magnetic resonance imaging conducted at 21 months. The authors report a case of selective coiling of a large, partially thrombosed basilar tip aneurysm.

• Advances in nano research
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• 제13권4호
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• pp.379-391
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• 2022

One factor that can heighten the risk of the rapture intracranial aneurysm (IA) is bifurcations, which can cause the IA to evaluate. This study presents the effect of geometric of intracranial vascular on the bifurcation analysis of the aneurysm occurrence. The aneurysm mechanism is mathematically modeled based on the nano pipe structures under the thermal stresses, and the impact of the aneurysm geometric on the stability and bifurcation points is analyzed. Because of the dimension of these structures, the classical theories could not predict their behavior perfectly, so the nonclassical and nonlocal theories are required for the mechanical modeling of the aneurysm. The presented results show that the bifurcation point of the aneurysm mechanism is dependent on the environment temperature, and the temperature change plays an essential role in the stability of these structures.

• Journal of Chest Surgery
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• 제30권3호
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• pp.300-307
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• 1997

인제대학교 부속 부산백병 원 흉부외과학교실에서는 지난 87년 10월부터 96년 1월까지 총25례의 흉부 및 복부 대동맥류를 수술로 치험하였다. 환자의 연령은 최소 26세에서 최고 73세(평균연령 52. 5세)였으며 남자가 13명 여자가 12명이였다. 발생 부위에 따라흉부 대동맥류가 18례 복부 대동맥류가7례였다. 원인에 따른 분류에서 16례가 박리성이 였으며 9례가 비박리성 대동맥류였다. 동맥류의 위험 인자로는 고혈압이 가장 많았으며 기타 고지질증, Marfan증후군등이였다. 흉부 대동맥류는 침범 부위에 따라 동맥류 절제술과 인조혈관 대치술 및 관상동맥 이식술등을 증례에 따라적절히 시행하였다. 복부 대동맥류는 동맥류 절제후 침범 부위에 따라 일자 또는 역Y형 인조혈관 을 대 치시켰다. 총 5례의 술후 사망이 있어서 수술 사망률은 20%였으며 생존 환자는 특별한 합병증 없이 퇴원하였다.

• International Journal of Vascular Biomedical Engineering
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• 제2권2호
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• pp.10-15
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• 2004

Purpose: In the treatment of aortic aneurysm, endovascular stent-graft application has become an established method of treatment. To observe the outcomes of the procedure as the size change of aneurysm in relation with endoleak, a retrospective analysis was done for the consecutive cases who undertook the procedure. Materials & Method: Stent-graft was applied to the aortic aneurysm in 33 patients. The location of the aneurysm was thoracic in 11 patients and abdominal in 22 patients. CT angiographic was done for the follow-up evaluation to analyze the aneurysm size and the presence of endoleak. Results: Technical success rate was 97% (32/33). The primary success rate without endoleak was 84% (28/33). The secondary success was 90% (30/33). During the follow-up period of 3 months to 7years and 6months in 26 patients, a secondary endoleak developed in 5 cases. Post-implantation syndrome developed in 17 cases (51%). Among the 14 cases with follow-up imaging data for size, endoleak was negative in 10 cases. The aneurysm decreased in 5 cases, stable in size in 4 cases and enlarged in one case (10%).Among the 4 cases with endoleak positive, the aneurysm enlarged in two cases (50%). Conclusion: In the stent-graft application for aortic aneurysm, there is high chance of decrease of aneurysm size in those cases with endoleak negative. However, the aneurysm may increase and eventually rupture in the cases with en do leak positive. Close observation with CT angiography is necessary for the evaluation for the presence of endoleak and size change.

• 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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• 제37권3호
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• pp.223-227
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• 2005

Systemic multiple aneurysms are rare, and an association between intracranial and visceral arterial or abdominal aortic aneurysm in the same patient is a very rare occurrence. We report herein three such cases. In one case, aneurysms of the right internal carotid artery(ICA) and the right middle cerebral arterial bifurcation(MCAB) coexisted with the inferior pancreaticoduodenal arterial pseudoaneurysm and two ileal arterial aneurysms. In another case, the patient had the A-com arterial aneurysm and the right renal arterial aneurysm. And in the other patient, he had the right vertebral artery dissecting aneurysm with the abdominal aortic aneurym. Initially, all patients were referred to our hospital with subarachnoid hemorrhage(SAH), and thereafter first two patients developed visceral arterial aneurysm rupture in the course of hospital stay and in the last patient, the abdominal aortic aneurysm was detected incidentally during carotid angiogram for Guglielmi detachable coil(GDC) embolization of vertebral dissecting aneurym. After thorough review of our cases together with pertinent literatures, we emphasize the possibility of underlying extracranial aneurysms in ruptured intracranial arterial aneurysm patient and it's uncommon but fatal complication.

• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.265-269
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• 2000

Traumatic aneurysm is a rare complication of head trauma. Unfortunately, it is rarely recognized until their presence is heralded by delayed deterioration or intracranial hematoma, etc,. Early diagnosis and surgical treatment are most important for good outcome. We recently encountered a patient who developed a pericallosal aneurysm after major trauma. With a high index of suspicion about traumatic aneurysm, brain MRI and MRA were performed. Definitive diagnosis was made by transfemoral carotid angiography, revealing a aneurysm of the right proximal pericallosal artery. The aneurysm was explored through right interhemispheric approch. A $15{\times}15mm$ sized traumatic aneurysmal sac, located in proximal portion of right pericallosal artery was noted. It was dissected from the falx of cerebri and its neck was clipped. The postoperative course was uneventful. Traumatic intracranial aneurysm should be suspected in any patient who deteriorates after the trauma. Early recognition and prompt treatment are warranted in this setting. Definitive surgical treatment of all traumatic intracranial aneurysm is recommended.