Multiple intracranial aneurysms: the role for simultaneous open microsurgical treatment

Area of Science:

• Neurosurgery
• Vascular Neurology
• Cerebrovascular Disease

Background:

• Multiple intracranial aneurysms (MIAs) present significant clinical risks.
• Treatment options for MIAs include open surgical, endovascular, and hybrid techniques.
• Single-stage treatment is ideal for MIAs when feasible.

Purpose of the Study:

• To evaluate the outcomes of single-stage microsurgical treatment for MIAs.
• To provide an updated literature review in the context of endovascular advancements.
• To assess the safety and efficacy of open microsurgery for simultaneous MIA treatment.

Main Methods:

• Retrospective review of 52 patients with MIAs treated between January 2014 and May 2024.
• Data collected included patient demographics, aneurysm characteristics, treatment details, and outcomes.
• Single-stage microsurgical clipping was the primary treatment modality.

Main Results:

• 52 patients (84.6% female, mean age 58.6) with 2-3 aneurysms were treated.
• 95.7% of aneurysms were in the anterior circulation; 30.8% presented with aneurysmal subarachnoid hemorrhage (aSAH).
• 98.1% achieved complete aneurysm occlusion, and 96.2% were functionally independent at follow-up.

Conclusions:

• Open microsurgery is an efficacious and safe option for simultaneous MIA treatment.
• Appropriate patient selection is key for successful single-stage microsurgical intervention.
• The study supports microsurgery as a viable treatment for MIAs, even in the endovascular era.