One-Stage Endovascular Embolization for Multiple Intracranial Aneurysms

Clinical treatment of multiple intracranial aneurysms remains challenging due its higher rate of rupture compared to a single aneurysm. We aimed to assess the efficacy of one-stage endovascular embolization for treatment of multiple intracranial aneurysms.

We treated 72 aneurysms from 33 patients with one-stage endovascular embolization from September 2010 to October 2015. Of these, 60 aneurysms were treated with coils, while 12 wide-neck aneurysms were embolized with the assistance of intracranial stents. Follow-up studies ranged from 3 to 28 months, and patient outcomes were assessed using the modified Rankin Scale (mRS) and digital subtraction angiography (DSA).

All aneurysms were embolized successfully and no complications occurred. DSA immediately after procedure revealed that complete occlusion was achieved in 39 cases, neck remnant was observed in 27 cases, and a residual aneurysm remnant was observed in six cases. All patients achieved excellent clinical outcomes following embolization (27 patients with a mRS score of 0 and 6 with a mRS score of 1). Six months after the procedure, DSA was performed on 28 patients, revealing one case with a neck remnant, and two cases with completely occluded aneurysms. Despite these outcomes, there was no rupture or hemorrhage of these aneurysms throughout the six months.

One-stage endovascular embolization is a safe and effective treatment for multiple intracranial aneurysms, but long-term outcomes should be further evaluated.