Pure endoscopic clipping of anterior circulation aneurysms through keyhole approach

Abstract

Objective: This retrospective study evaluated the safety and effectiveness of pure endoscopic clipping for anterior circulation aneurysms through the supraorbital keyhole approach and the pterional keyhole approach. Methods: We included 92 patients with anterior circulation aneurysms, all treated with clipping surgery at The First Affiliated Hospital of Bengbu Medical University. Patients were divided into neuroendoscopic and microscopic groups, based on whether endoscopic or microscopic techniques were used for clipping. We analyzed baseline patient characteristics, surgery-related details, postoperative hospitalization duration, complications, and modified Rankin Scale (mRS) scores 3 months after the operation to assess treatment outcomes. Results: No significant differences existed between the neuroendoscopic and microscopic groups in statistical indicators, except for patient gender distribution. Conclusions: Pure neuroendoscopic clipping of anterior circulation aneurysms (≤1cm in diameter, Hunt-Hess grade ≤ III) through supraorbital and pterional keyhole approaches is safe and effective. Its prognosis is comparable to that of the microscopic keyhole approach. Moreover, since the endoscope can provides better light intensity deep in the surgical field, clear close-up images of pathoanatomic details, and wider viewing angles, endoscopic clipping of intracranial aneurysms is more valuable.