추골 동맥류의 수술경험
Clinical Analysis and Surgical Treatment. of Vertebral Aneurysm
소속 상세정보
이중석/Jung Seok Yi
김국기/임영진/김태성/이봉암/임언/Gook Ki Kim/Young Jin Lim/Tae Sung Kim/Bong Arm Rhee/Won Leem
KMID : 0359819970260010101
Abstract
결 론
본 교실에서는 지난 10년간 12례의 추골동맥류에서 수술적 치료를 하였으며, 골동맥류의
발생빈도는 1.6%였고, 치료결과는 Neurobehcet's disease로 사망한 1례를 제외한 나머지 11
례에서 모두 좋은 결과를 보였다.
추골동맥류의 진단시 반드시 양측추골동맥조영술을 실시해야하며 추골동맥결찰의 가능성
을 염두에 두고 반대측 추골동맥 등에 의한 측부순환의 정도를 파악하고 후교통동맥의 내경
의 크기 등을 보기 위해 Aircock's test를 시행해야 한다.
추골동맥류에서 낭상동맥류의 경우 직접경부결찰술의 수술 결과는 우수했으며 해리성동맥
류와 방추상동맥류의 경우처럼 직접경부결찰술이 불가능할 경우 추골동맥결찰술을 시행하는
것이 바람직하며 이의 수술결과 또한 우수하였다
매우 드문 경우이지만 Behcet's disease의 경우 뇌혈관에 다양한 병소를 유발시키는
Neurobehcets disease 발병 가능성 이 있어 그 진단 및 치료에 주의를 요한다.
#초록#
Aneurysms of the vertebral artery are relatively uncommon. Diagnosis and treatment
of such condition aneurysm has a potentially higher degree of technical difficulty
We retrospectively analyzed the clinical features and therapentic outcomes ol 12
consecutive patients with vertebral aneurysms that we haute encountered during the last
11 years Most of these aneurysms occurred in females(9 of 12). Eight patients presented
as classic subarachnoid hemorrhage. terce were diagnosed Incidentally, the other one
patient had fusiform aneurysm presented with mass effect. Among the If, there were 7
saccular aneurysms, 2 fusiform aneurysms, and 3 dissecting aneurysms Eight of these
were located at the origin of the posterior cerebellar artery(PICA). two were at the
junction of the vertebral and basilar arteries. and two at the distal portion of PIGA
Direct neck clipping was performed in 8 patients and proximal ligation of the oral artery
was done in 4 patients due to the impossibility ol direct neck clipping.
Eleven of them experienced no major morbidity However one patient wish fusiform
aneurysm treated by Vertebral artery clipping developed right cerebellar hemispheric
infarction Unfortunately this patient died 10 months after surgery due to lung abscess
related to Behcet's disease.
키워드
Vertebral aneurysm; Neck clipping; Froximal ligation Bahcet's disease; PIGA aneurysm.;
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