Endoscopic-guided clipping of cerebral aneurysms

An endoscopic probe has been used intraoperatively to facilitate the obliteration of cerebral aneurysms. This method has been used in 24 patients with 30 arterial aneurysms. There were 13 males and 11 females. They ranged in age from 22 to 73 years (mean age 48 years). The mean time of surgery was 7.3 days after subarachnoid haemorrhage (ranging from 2 to 24 days). In three cases there was intraoperative rupture of the aneurysm and with one patient the operation had to be abandoned because of severe brain oedema. The follow-up ranged from 12 to 48 weeks (average 31.8 weeks). The overall outcome was good in 14 cases (58.3%), eight patients (33.3%) showed moderate disability, severe disability occurred in one patient (4%) and one patient (4%) died. In all cases when the endoscope was used, there was a striking improvement in the visualisation of the anatomy of the aneurysm and surrounding structures. Furthermore, the position of the clip and the state of the vessels leading to and from the aneurysm could be easily examined.