The surgical treatment outcomes at patients with multiple cerebral aneurysms
Objective: to justify the strategy of treatment of patients with multiple cerebral aneurysms based on results of analysis of surgical treatment outcomes. Material and methods. Our study included 471 patients with multiple cerebral aneurysms treated at the base of Scientific Research Institute of Neurosurgery named after N.N. Burdenko from 1995 till 2011. We analyzed the results of single-and multistage operations as well as operations with combination of microsurgical and endovascular techniques. Results. Postoperative lethality was 3,4%. Severe invalidization was observed at 43 (9,2%) patients. The number of completely treated aneurysms (fully turned out from blood flow) was significantly higher in the group with multistage operations — 92% comparing with 80% (p<0,05) in the group with singlestage operations, and the number of palliative operations and non-operated aneurysms — significantly lower (3,8% comparing with14,7% (p < 0,05)). The best technical and clinical outcomes were obtained in the group of patients received step-by-step operations with combination of endovascular and microsurgical technique. There were no unfavorable outcomes in this group of patients and number of completely treated aneurysms achieved in 90,2% of patients. Conclusion: The obtained results of multiple cerebral aneurysms treatment allow considering the multistage operation is the most preferable method for multiple cerebral aneurysm surgical treatment and indicating the high effectiveness of multimodal approach with integration of endovascular and microsurgical methods especially in case of carotid and vertebrobasilar aneurysms combination.