코일 색전술과 결찰술로 치료한 두개강내 키싱동맥류의 두가지 증례보고

초록

PURPOSE : Kissing aneurysm has been known as a rare type of aneurysm. We report two case of intracranial “kissing aneurysm” . Through the review article about kissing aneurysm, we discuss the treatment modality of kissing aneurysm and factors that affect the choice of kissing aneurysm’s treatment modality. MATERIALS AND METHODS : From January 2003 to January 2009 in our hospital, total 445 cerebral aneurysm patients had operation with aneurysmal neck clipping or coil embolization, and retrograde analysis was done with medical records and radiologic reports(including CT angiography and catheter angiography). Among the patient with multiple aneurysm, two patients had kissing aneurysm. It was treated through aneurysmal neck clipping and coil embolization. RESULTS : A 59-year-old female has a unruptured anterior communicating artery bilobulated kissing aneurysms it seemed to be that two saccular aneurysm was pressing together at infundibular part. We clipped those aneurysms successively within separate manner. Another case was 42-year-old male admitted for traumatic subdural hematoma. During the admitted, we founded unruptured aneurysms on right internal carotid artery as a anterior choroidal artery and posterior communiocating artery. These aneurysms were treated with coil embolization because chronic subdural hematoma operation was needed. Surgical treatment was too risky in this case because they shared the parent artery. CONCLUSION : Kissing aneurysms are rare type of multiple aneurysm. Also we have to choose treatment modality of kissing aneurysm carefully, because many factors have a potential to hinder surgical clipping or endovascular treatment.