The Second-Set Surgeries for Multiple Unruptured Aneurysms Do Not Increase Perioperative Complications

Area of Science:

• Neurosurgery
• Vascular Neurology
• Interventional Neuroradiology

Background:

• Multiple intracranial aneurysms affect 20-25% of individuals with aneurysms.
• Aggressive treatment is recommended due to higher rupture and enlargement risks compared to single aneurysms.
• Risks and optimal timing of secondary clipping surgeries for multiple aneurysms are underreported.

Purpose of the Study:

• To assess the prognosis and risks associated with a second clipping surgery for multiple unruptured cerebral aneurysms.
• To determine if the timing of secondary surgeries influences patient prognosis and complication rates.

Main Methods:

• Retrospective review of patients undergoing secondary clipping surgery for multiple unruptured cerebral aneurysms.
• Comparison of aneurysm characteristics, demographics, and antithrombotic drug use between first and second surgeries.
• Investigation of modified Rankin Scale scores and postoperative complications (ischemia, hemorrhage, seizures, etc.).

Main Results:

• 38 patients (mean age 65) were analyzed.
• No significant differences in modified Rankin Scale score worsening, hospital stay, or complication rates between the first and second surgeries.
• Older patients had second surgeries within 6 months, with similar complication rates; the first surgery targeted larger aneurysms.

Conclusions:

• The absence of complications between surgeries and during follow-up supports individualized treatment approaches.
• First and second clipping surgeries for multiple cerebral aneurysms did not significantly impact postoperative complications.
• Performing two craniotomies can facilitate curative and safe treatment for multiple aneurysms.