지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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초록· 키워드
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Objective : The purpose of this study was to analyze the clinical and anatomic features involved in determining treatment modalities for anterior communicating artery (AcoA) aneurysms. Methods : The authors retrospectively evaluated 112 AcoA aneurysms with pretreatment clinical features including age, Hunt and Hess grade, medical or neurological comorbidity, and anatomical features including aneurysm size, neck size, dome-to-neck ratio, vessel incorporation, multiple lobulation, and morphologic scoring system. Post-treatment clinical results were classified according to the Glasgow Outcome Scale, and anatomic results in coiled patients were classified according to the modified Raymond scale. Using multivariate logistic regression, the probabilities for decision making between surgical clipping and coil embolization were calculated. Results : Sixty-seven patients (60%) were treated with surgical clipping and 45 patients (40%) with endovascular coil embolization. The clinical factor significantly associated with treatment decision was age (${\geq}$65 vs. <65 years) and anatomical factors including aneurysm size (small or large vs. medium), dome-to-neck ratio (<2 vs. ${\geq}$2), presence of vessel incorporation, multiple lobulation, and morphologic score (${\geq}$2 vs. <2). In multivariate analysis, older patients (age, 65 years) had significantly higher odds of being treated with coil embolization relative to clipping (adjusted OR=3.78; 95% CI, 1.39-10.3; p=0.0093) and higher morphological score patients (${\geq}$2) had a higher tendency toward surgical clipping than endovascular coil embolization (OR=0.23; 95% CI, 0.16-0.93; p=0.0039). Conclusion : The optimal decision for treating AcoA aneurysms cannot be determined by any single clinical or anatomic characteristics. All clinical and morphological features need to be considered, and a collaborative neurovascular team approach to AcoA aneurysms is essential.
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참고문헌 (30)
참고문헌 신청
Barker FG / 2004 / Age-dependent differences in short-term outcome after surgical or endovascular treatment of unruptured intracranial aneurysms in the United States, 1996-2000 / Neurosurgery 54:18~30
Bendok BR / 2003 / Coil embolization of intracranial aneurysms / Neurosurgery 52:1125~1130
Brisman JL / 2006 / Cerebral aneurysms / N Engl J Med 355:928~939
Byrne JV / 1999 / Five-year experience in using coil embolization for ruptured intracranial aneurysms : outcomes and incidence of late rebleeding / J Neurosurg 90:656~663
Cognard C / 1999 / Long-term angiographic follow-up of 169 intracranial berry aneurysms occluded with detachable coils / Radiology 212:348~356
Bendok BR / 2003 / Coil embolization of intracranial aneurysms / Neurosurgery 52:1125~1130
Brisman JL / 2006 / Cerebral aneurysms / N Engl J Med 355:928~939
Byrne JV / 1999 / Five-year experience in using coil embolization for ruptured intracranial aneurysms : outcomes and incidence of late rebleeding / J Neurosurg 90:656~663
Cognard C / 1999 / Long-term angiographic follow-up of 169 intracranial berry aneurysms occluded with detachable coils / Radiology 212:348~356
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