title: Treatment of multiple intracranial aneurysms with 1-stage coiling.
abstract: OBJECTIVE
  Although multiple intracranial aneurysms are frequent, determining treatment strategy and methods for them is often complicated. The aim of this study was to evaluate the safety and effectiveness of 1-stage coiling for multiple intracranial aneurysms.
  
  
  METHODS
  All patients who underwent 1-stage coiling for ≥2 aneurysms were identified from a prospectively registered neurointerventional data base during 10 years. The patient characteristics and clinical and angiographic outcomes at discharge and follow-up were retrospectively evaluated.
  
  
  RESULTS
  One hundred sixty-seven patients (male/female ratio, 30:137; mean age, 58 years) with multiple aneurysms (418 aneurysms; mean, 2.5 aneurysms/patient) underwent attempted 1-stage coiling for ≥2 aneurysms (359 aneurysms; mean, 2.1 aneurysms/patient). In 131 patients (78.4%), all detected aneurysms were treated with coiling only. Treatment-related morbidity and mortality at discharge were 1.8% and 0.6% per patient, respectively. Of the 132 patients without subarachnoid hemorrhage, 129 (97.7%) had favorable outcomes (mRS 0-2) at discharge; of the 35 patients with SAH, 27 (77.1%) had favorable outcomes at discharge. Of the 162 patients (97%) for whom clinical follow-up was available (mean, 35.8 months), 154 patients (95.1%) had favorable outcomes. Immediate posttreatment angiography showed complete occlusion in 186 (51.8%) aneurysms, neck remnants in 134 (37.3%), sac remnants in 33 (9.2%), and failure in 6 (1.7%). Of the 262 (73.9%) aneurysms that underwent follow-up imaging (mean, 24.8 months), 244 (93.1%) showed a stable or improved state, with 12 (4.6%) minor and 6 (2.3%) major recurrences.
  
  
  CONCLUSIONS
  One-stage coiling of multiple aneurysms seems to be safe and effective, with low morbidity and mortality.
authors.affiliation: From the Department of Radiology (P.J.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: P
authors.initials: P
authors.lastname: Jeon
authors.affiliation: Department of Radiology (B.M.K., D.J.K., D.I.K.), Severance Hospital.
authors.forename: B M
authors.initials: BM
authors.lastname: Kim
authors.affiliation: Department of Radiology (B.M.K., D.J.K., D.I.K.), Severance Hospital.
authors.forename: D J
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Department of Radiology (B.M.K., D.J.K., D.I.K.), Severance Hospital bmoon21@hanmail.net.
authors.forename: D I
authors.initials: DI
authors.lastname: Kim
authors.affiliation: Department of Radiology (S.H.S.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Suh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D008297:Male; D061185:Mechanical Thrombolysis / Q000295:instrumentation* / Q000401:mortality*; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D015995:Prevalence; D011859:Radiography; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome