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Kheireddin A.S.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Filatov Iu.M.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Belousova O.B.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Éliava Sh.Sh.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Yakovlev S.B.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

Sazonov I.A.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Pilipenko Iu.V.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Mikeladze K.G.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

Kaftanov A.N.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Vinogradov E.V.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

Substantiation of differentiated management of patients with multiple cerebral aneurysms

Authors:

Kheireddin A.S., Filatov Iu.M., Belousova O.B., Éliava Sh.Sh., Yakovlev S.B., Sazonov I.A., Pilipenko Iu.V., Mikeladze K.G., Kaftanov A.N., Vinogradov E.V.

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Journal: Burdenko's Journal of Neurosurgery. 2012;76(3): 45‑53

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SUBSTANTIATION OF DIFFERENTIATED MANAGEMENT OF PATIENTS WITH MULTIPLE CEREBRAL ANEURYSMS
SUBSTANTIATION OF DIFFERENTIATED MANAGEMENT OF PATIENTS WITH MULTIPLE CEREBRAL ANEURYSMS

To cite this article:

Kheireddin AS, Filatov IuM, Belousova OB, et al. Substantiation of differentiated management of patients with multiple cerebral aneurysms. Burdenko's Journal of Neurosurgery. 2012;76(3):45‑53. (In Russ.)

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)
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Abstract:

The study was performed to substantiate optimal tactics of management of patients with multiple cerebral aneurysms based on analysis of surgical results. This study included 233 (20%) patients with multiple cerebral aneurysms who were treated in Burdenko Neurosurgical Institute since 1995 till 2007. We analyzed results of single-stage (microsurgical technique) and multi-stage (microsurgical technique and step-by-step application of endovascular and microsurgical techniques) approaches. The following factors were investigated: severity of subarachnoid hemorrhage (Hunt-Hess scale), localization of aneurysms in different arterial systems, quantity and size of aneurysms.. Postoperative mortality was 4.7%. Poor outcomes were observed in 37 (16%) patients. In multi-stage surgical treatment the number of totally occluded aneurysms was significantly higher (92% vs. 79%, p<0.05) as the number of palliative operations and untreated aneurysms was lower (5.8% vs. 16%, p<0.05). The best technical and clinical results were obtained in the group of patients who were treated using step-by-step application of endovascular and microsurgical techniques. Despite coexistence of aneurysms of both carotid systems with vertebrobasilar aneurysms in 15% of this group, poor outcomes were not observed and total occlusion of aneurysms was performed in 91.4% of cases. Obtained technical and clinical results of treatment of multiple aneurysms prove that multi-stage surgical management is the therapy of choice in surgery of multiple aneurysms. Our data demonstrate high effectiveness of multimodal approach with integration of endovascular and microsurgical methods. Combination of both techniques is preferential in coexistence of aneurysms of carotid and vertebrobasilar systems.

Keywords:

multiple cerebral aneurysms
aneurysm clipping
aneurysm coiling
multistage surgery

Authors:

Kheireddin A.S.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Filatov Iu.M.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Belousova O.B.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Éliava Sh.Sh.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Yakovlev S.B.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

Sazonov I.A.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Pilipenko Iu.V.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Mikeladze K.G.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

Kaftanov A.N.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Vinogradov E.V.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

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