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Updated: Jul 9, 2026
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Fully endoscopic keyhole approach for intracranial aneurysm clipping: clinical outcomes and technical note
Lulu Chen1, Yuchun Shang2, Yu Li2
1Department of Neurosurgery, The First Affiliated Hospital of Bengbu Medical University, No.287 Changhuai Road, Bengbu, 233000, Anhui, China. ldenny@163.com.
Background:
Surgical clipping is often utilized to treat intracranial aneurysms. The application of the endoscopy and keyhole approach in neurosurgery is increasing gradually in intracranial aneurysm occlusion. The aim of this study is to evaluate the role of fully endoscopic keyhole approach in clipping of intracranial aneurysms.
Methods:
We retrospectively analyzed four cases of intracranial aneurysms, including three cases of middle cerebral artery bifurcation aneurysms (M1) and one case of anterior communicating aneurysms (ACoA). Among them, the anterior communicating aneurysm underwent fully endoscopic clipping via supraorbital keyhole approach and the middle cerebral aneurysms underwent fully endoscopic clipping via mini-pterional keyhole approach. The clipped aneurysms were evaluated by Digital Subtraction Angiography (DSA).
Results:
All patients had satisfactory cerebral aneurysm clipping via the endoscopic keyhole approach. There was no cerebral hemorrhage, cerebral infarction, cerebral vasospasm. One case of intracranial infection was cured by active anti-infection. No recurrence of aneurysms after 6 months of follow-up.
Conclusion:
With the advantages of the endoscopy and keyhole approach, the excellent visual field of the endoscope can reduce the influence of intracranial aneurysmal neck residual and perforating vessel. However, endoscopic clipping of intracranial aneurysms in narrow corridors requires a learning curve.
