뇌동맥류 코일 색전술시 발생한 코일의 절단과 치료

초록

목 적 : Following increase of coil embolization, there results were growing better and better in case of intracranial aneurysmal subarachnoid hemorrhage, complications and technical problems were increased, too. So we were reported our unusual experience of coil broken during coil embolization in aneurysmal subarachnoid hemorrhage with literature reviews. 대 상 : A 63-aged man was admitted our hospital because of spontaneous subarachnoid hemorrhage due to anterior communicating artery aneurysmal rupture(H-H grade IV and Fisher grade III). We were chosen coil embolization because of suspected atrial fibrillation and uncontrolled diabetes. After packing of first selected coil(Ultrasoft, 4x30, Cordis), anteriorcommunicating artery obliteration was noted. So, we decided coil remove. movement, vessel occlusion, aneurysmal perforation and thromboembolism. But broken of coil was very rare. In reported case of SR type of GDC, repeated coil moving or bending was main reason of broken. In our case, the coil broken was developed at first attept to embolization. We were suspected mal-product, intra-microcatheter kinking due to clot and/or microcatheter wedge. 결론: There were highly morbidity and mortality was expected in case of coil broken. We must do careful inspection of microcateter and coil before procedure. In case of coil broken, we recommended cessation of procedure and considered surgical remove, because continuing procedure make high morbidity and mortality.