Simultaneous Craniotomies for Multiple Intracranial Aneurysm Clippings – One-stage Surgery with Multiple Craniotomies

Abstract Objective The treatment of multiple intracranial aneurysms (MIAs) involves various modalities and sometimes requires staged operations. This study aimed to prove the efficacy and safety of one-stage multiple craniotomies (OSMC) for multiple cerebral aneurysms. Methods We retrospectively reviewed the medical records of the patients who underwent treatment for intracranial aneurysms between May 2003 and April 2020. The surgical results, complications, and lengths of hospital stay were compared between the patients who underwent OSMC and those who underwent multi-stage multiple craniotomies (MSMC). Results The demographic characteristics of the OSMC and MSMC groups (n=82 and 43, respectively) were similar. There were no statistically significant differences between the two groups when the amount of blood transfused, complications, and surgical results were compared (p=n.s. for all); however, the operation time and hospitalization period (353.9 min vs. 490.3 min and 12.3 days vs. 21.8 days, respectively; p=0.001 for both) were shorter in the OSMC group. The treatment cost (17,000 USD vs. 22,000 USD, p=0.001) was lower in the OSMC group. Conclusions OSMC for aneurysm clipping in patients with MIAs is a relatively safe and economical method. Furthermore, it has good clinical outcomes. This new surgical method is worthwhile in that it can be applied to patients who are afraid to undergo multiple surgeries, and we suggest it is an efficient, low-cost option for the treatment of MIAs.