title: Comparison of surgical and endovascular approaches in the management of multiple intracranial aneurysms.
abstract: OBJECTIVE
  To investigate the outcomes and safety of endovascular compared with surgical clipping for multiple intracranial aneurysms.
  
  
  METHODS
  98 patients with 260 multiple intracranial aneurysms were treated with endovascular, surgical clipping, combined treatment, and observation. Data were retrospectively studied following treatment and at follow-up.
  
  
  RESULTS
  In the endovascular group, 44 aneurysms were treated with coils only and 29 aneurysms were treated with stent deployment. The complete occlusion rate was 65%, and the total complication rate was 12% with no permanent deficit. After angiographic follow-up for 1-90 (mean 62) months, the total recurrence rate was 18.3%. In the clipping group, 65 aneurysms were clipped. The complete occlusion rate was 90.8%, and the complication rate was 10.9% with 1 permanent deficit. After follow-up for 11-71 (mean 49) months, the angiographic recurrence rate was 1.5%. In the combination group, 20 aneurysms were treated endovascularly. The complete occlusion rate was 78.9%, and the complication rate was 15.8% with no permanent deficit. Twenty-eight aneurysms were treated surgically with the complete occlusion rate of 89.3%, the complication rate of 20% and 3 permanent deficits. After follow-up for 1-93 (mean 58) months, the angiographic recurrence rate was 33.3% for embolization and 3.6% for clipping. Seventy-four aneurysms for observation had 2.7% regrowth rate within 1-3 years.
  
  
  CONCLUSIONS
  Endovascular embolization has an accepted complication rate but no neurological deficits compared with surgical clipping and may be a better approach for multiple intracranial aneurysms than surgical clipping.
authors.affiliation: Emergency Department, People's Hospital of Rizhao, Rizhao, Shandong, PR China. Electronic address: dqlrz@163.com.
authors.forename: Qing-Lin
authors.initials: QL
authors.lastname: Dong
authors.affiliation: Departments of Medical Research and Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang, Hebei, PR China. Electronic address: browngao@163.com.
authors.forename: Bu-Lang
authors.initials: BL
authors.lastname: Gao
authors.affiliation: Emergency Department, People's Hospital of Rizhao, Rizhao, Shandong, PR China.
authors.forename: Zhong-Rong
authors.initials: ZR
authors.lastname: Cheng
authors.affiliation: Emergency Department, People's Hospital of Rizhao, Rizhao, Shandong, PR China.
authors.forename: Yan-Yan
authors.initials: YY
authors.lastname: He
authors.affiliation: Departments of Medical Research and Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang, Hebei, PR China.
authors.forename: Xue-Jing
authors.initials: XJ
authors.lastname: Zhang
authors.affiliation: Departments of Medical Research and Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang, Hebei, PR China.
authors.forename: Qiong-Ying
authors.initials: QY
authors.lastname: Fan
authors.affiliation: Departments of Medical Research and Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang, Hebei, PR China.
authors.forename: Cong-Hui
authors.initials: CH
authors.lastname: Li
authors.affiliation: Departments of Medical Research and Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang, Hebei, PR China.
authors.forename: Song-Tao
authors.initials: ST
authors.lastname: Yang
authors.affiliation: Departments of Medical Research and Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang, Hebei, PR China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Xiang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D002681:China; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Complication; Endovascular; Multiple intracranial aneurysms; Outcome; Surgical clipping