[Application of the neuro-endoscope to the intracranial aneurismal surgery]

To study the role of neuro-endoscope in the intracranial aneurismal surgery, analyzing its benefits, and disadvantages.

Endoscopy was used as an adjunct in the microsurgical treatment of clipping aneurysms on 88 patients with 89 aneurysms, of which 82 aneurysms in 81 patients were located in the anterior circulation and 7 were located in the posterior circulation. Keyhole approach was performed on all patients, and micro-Doppler ultrasound technique was used before and after clipping. In 84 aneurysms, endoscope-assisted microneurosurgery (EAM) was used in addition to microsurgical dissection and clipping so as to observe the neck anatomic features and perforators and to verify the optimal clipping position. Endoscope-controlled microneurosurgery was used for 5 aneurysms to observe the anatomy around aneurysm, such as the posterior communicating artery and the opposite anterior communicating artery behind the internal carotid artery.

Postoperative angiography performed on 86 patients showed satisfactory aneurysm clipping. Operative mortality was 0. There were 7 cases of postoperative complications, with an incidence rate of 7.95%, and none case was directly related to endoscopy.

Improving observation of regional anatomy because of its ability in magnification, illumination, and looking around dead angle, neuro-endoscopy is very useful for complex aneurysms.