Contralateral Clipping of Multiple Intracranial Aneurysms

Area of Science:

• Neurosurgery
• Vascular Neurology
• Interventional Neuroradiology

Background:

• Multiple intracranial aneurysms (MIA) represent 7-35% of all intracranial aneurysms.
• Current management prioritizes securing ruptured aneurysms while treating others without compromising patient outcomes.
• Endovascular treatment is preferred for bilateral MIA amenable to single-stage intervention.

Purpose of the Study:

• To evaluate the feasibility and safety of unilateral craniotomy for clipping bilateral multiple intracranial aneurysms in a single stage.
• To compare this approach with staged bilateral surgeries or endovascular treatments.

Main Methods:

• Retrospective analysis of patients with bilateral MIA treated via unilateral craniotomy and clipping.
• Careful patient selection based on aneurysm complexity, location, and patient factors.
• Comparison of outcomes, morbidity, and treatment costs with staged approaches.

Main Results:

• Unilateral craniotomy for bilateral MIA clipping is feasible and safe in properly selected cases.
• This single-stage approach can secure all aneurysms, decreasing morbidity and treatment costs.
• Meticulous patient selection is crucial for successful outcomes.

Conclusions:

• Unilateral craniotomy and clipping offer an effective single-stage treatment for selected cases of bilateral MIA.
• This strategy mitigates risks associated with staged treatments, such as re-bleeding and increased healthcare expenses.
• Careful case selection is paramount for optimizing safety and efficacy in managing complex MIA.