Clinical Analysis Of Different Surgical Strategies For Multiple Intracranial Aneurysms

Objective: Multiple intracranial aneurysms refer to the simultaneous occurrence of two or more intracranial aneurysms,which is a high-risk disease of the central nervous system.For patients with ruptured intracranial aneurysms and acute subarachnoid hemorrhage,surgical treatment should be taken in time to strive for a good prognosis.Based on the different characteristics of multiple intracranial aneurysms,surgical treatment strategies depend on different conditions.The purpose of this research is discussing the efficacy and principles of different surgical strategies in the treatment of multiple intracranial aneurysms,so as to provide a reference for clinical practice in the treatment of multiple intracranial aneurysms.Methods: Retrospectively analyzing clinical cases of 70 patients with multiple intracranial aneurysms treated in three neurosurgical wards of Shengjing Hospital Affiliated to China Medical University from August 2011 to December 2020.The general data of age,gender,preoperative Hunt-Hess classification,number and location of aneurysms were collected,All patients were divided into four groups: Intracranial clipping or endovascular coiling,unilateral or bilateral surgery,one-stage or staged surgery,treatment of responsible aneurysms or treatment of all aneurysms.Through the GOS score,postoperative rebleeding,postoperative complications and other prognostic indicators to comparing the therapeutic effect of different surgical strategies.Results: In univariate analysis,the clinical efficacy of endovascular coiling is better than that of intracranial clipping,and the clinical efficacy of dealing all aneurysms was better than that of only dealing with responsible aneurysms;the influence of surgical side and surgical stage on prognosis was not statistically significant;the postoperative rebleeding and postoperative complications were not statistically significant;In multivariate analysis,preoperative Hunt-Hess scores and the choice of surgical method were the independent risk factors affecting the prognosis the disease.Conclusion: The treatment of multiple intracranial aneurysms requires strict preoperative evaluation and definite preoperative diagnosis,and the most appropriate individualized surgical strategy should be selected according to the experience of the operator and the wishes of the patients and their families.The ruptured aneurysms with SAH should be treated as early as possible,and endovascular coiling should be chosen as the best operation method.However,intracranial clipping has irreplaceable advantages for some aneurysms with special nature and shape.Economic factors are also important factors for patients to choose intracranial clipping.All aneurysms should be treated as much as possible during the operation,but many factors should be considered when dealing with the UIA.The choice of surgical approach and the formulation of surgical staging should follow certain principles and combined with their own experience,in order to achieve a good prognosis for patients under safe and effective surgical treatment.