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Updated: Aug 7, 2025

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Endoscopic endonasal clipping of a medial paraclinoid aneurysm with roadmapping assistance: Two-dimensional operative
Marcos V Sangrador-Deitos1, German Lopez-Valencia1, Gerardo Y Guinto-Nishimura1
1Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
Background:
Advancements in endoscopic endonasal approaches (EEAs) allow the treatment of a wide variety of diseases including vascular pathology.
Case Description:
A 56-year-old woman presented with thunderclap headache due to two aneurysms: Communicating segment of left internal carotid artery (ICA) and medial paraclinoid (Baramii IIIB). The ICA aneurysm was clipped through a conventional transcranial approach; the paraclinoid aneurysm was successfully clipped using an EEA guided with roadmapping assistance.
Conclusion:
EEA is useful to treat aneurysms in selected cases and the use of adjuvant angiographical techniques such as roadmapping or proximal balloon control allow excellent control during the procedure.

