Patients with bilateral, multiple intracranial aneurysms (IA) can be safely treated using one lateral craniotomy. However, in patients with an additional PcaA or distal ACA aneurysm, an interhemispheric approach through a bifrontal craniotomy is needed. Here, we investigate the safety of a single incision with dual ipsilateral craniotomies ("squeeze play") and compare results to two separate staged surgeries.
Retrospective data collection and analysis of all patients with multiple IAs including a PcaA or complex ACA aneurysm between 1997 and 2016. Univariate statistical analysis was performed to compare radiological and clinical outcomes.
Both the squeeze play (n=12) and control group (n=16) showed similar female gender and mean age distribution with a higher mean aneurysm number in the squeeze play group. Indication for surgery was mainly SAH for the control group (12/16). Mean aneurysm diameter of the largest aneurysm treated with the lateral craniotomy was higher in the squeeze play group (15.8 vs 4.7mm, p=0.005) with comparable craniotomy types between both groups. Cumulative EBL was higher in the control group with a comparable cumulative OR time, reoperation rate and favorable clinical outcome in both groups.
Single-staged surgery with a single incision and dual ipsilateral craniotomies is a safe treatment for multiple unruptured aneurysms that include PcaA and distal ACA aneurysms. The squeeze play results in clinical and radiological outcomes comparable to a two-staged control group. In the setting of SAH, two-staged surgery with a recovery interval is preferred to prevent bilateral manipulation of the acutely injured brain.
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 July 2023.
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