Coating을 시행한 뇌동맥류 파열환자의 예후
Outcome of Ruptured Intracranial Aneurysms Treated by Coating
소속 상세정보
박종혁
석종식/목진호/박관/김영백/민병국/황성남/최덕영
KMID : 0359819950240060676
Abstract
In rare occasions in which aneurysmal neck clipping is nearly impossible, coating is employed. During the period from 1985 to 1992. 321 patients with aneurysm underwent surgery ; aneurysmal neck clipping were performed in 284 cases while coating
only in
28. The reasons that coating was required were ; wide and broad neck in 13, perforators arising from the neck in 4, neck tearing during dissection in 3, very friable neck in 2, severe adhesion with surrounding structures in 3. and small aneurysm
without
enough room for clipping in 3. In twenty-three cases. cotton wisp and bioglue were used as coating materials. In another five cases. the aneurysmal wall was reinforced using Surgicel or Gelfoam. Patients were followed for 24 months on average of
all the
patients. Four had last contack. Six died (4 due to rebleeding and 2 due to pneumonia). Fourteen were good and 4 were moderately disabled. There were no rebleeding incidences during first three months' follow-up after coating. We thus concluded
that
coating an aneurysm offers some protection from rebleeding particularly when the rebleeding risk period is over.
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