Comparison of clinical results of endovascular and open surgery methods in intracranial multiple aneurysms

In order to prefer open surgery in multiple aneurysms, we have determined that they are not suitable for endovascular treatment as our primary rule. We treated aneurysms that did not comply with endovascular treatment and could be clipped in a single session by clipping them. Coil/stent was definitely tried in aneurysms where coil-stent was suitable. If one aneurysm fits and the other does not, the endovascular one was performed first. Since complications can rarely occur with endovascular surgery, we gave priority to the aneurysm that would be closed with endovascular surgery, so that we would not have to go back to open surgery if we had problems closing another aneurysm with endovascular surgery after open surgery. If the dome/neck ratio was above 1.5-2 and if it was larger than 2 mm and there was no branch coming out of it, coil winding was applied. We find it wrong to apply stents to MCA aneurysms due to the risk of occlusion and embolism. Since MCA aneurysms are common at the bifurcation, they are generally not suitable for coiling. Open aneurysms also have good results. Therefore, if they are not suitable for coiling, open surgery is the most appropriate method. ICA aneurysms are generally suitable for treatment with stents and coils. If the general conditions are met, treatment with endovascular treatment will give good results. If coil cannot be wrapped in ICA aneurysms that are in difficult to reach surgically, stent-supported coil will be the most appropriate method. If ACom aneurysms point posteriorly, conditions must be strictly enforced for coil or stent-supported coil. However, in the anterior projection, endovascular treatment should be considered, depending on the dome/neck ratio and the rules of whether or not branches emerge from it, and if necessary, the results of open surgery are also good. In posterior circulation aneurysms, the endovascular method should still be enforced. Open surgery should be performed for aneurysms that cannot be closed by endovascular method. With these results, the results of whichever type of aneurysm is associated with multiple aneurysms should be combined and applied. An attempt has been made to develop a perspective together with what is applied to multiple intracranial aneurysms, which are still not easy to treat today. It is a fact that we get better results with the development of technology. This study will shed light on future results by comparing it with larger patient groups and possible new techniques.