Endoscope-assisted microneurosurgery for intracranial aneurysms: A systematic review and meta-analysis

Shao, Dongqi; Liu, Yu; Zhang, Binbin; Wu, Jun-Yong; Xie, Shan; Zheng, Xia‐Lin; Jiang, Zhiquan

doi:10.1016/j.jocn.2022.06.029

Cited by 5 publications

(3 citation statements)

References 37 publications

(92 reference statements)

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“…Even among experienced surgeons, unexpected perforating arteries occlusion and incomplete clipping of aneurysm neck have been reported [19].Compared with a microscope, the endoscope provides better light intensity deep in the surgical eld, clear close-up images of pathoanatomic details, and wider viewing angles [20]. These characteristics of endoscope are helpful for surgeons to better expose the neck of aneurysm and understand the relationship between aneurysms and perforating blood vessels and surrounding adjacent blood vessels [19,[21][22].One of our previous meta-analyses have shown that 77% of endoscopic-assisted surgeries offer crucial visual information over standard microsurgery [23]. Besides.…”

Section: Discussionmentioning

confidence: 99%

Pure endoscopic clipping of anterior circulation aneurysms through keyhole approach

Tang,

Niu,

Zheng

et al. 2024

Preprint

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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.

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Section: Discussionmentioning

confidence: 99%

Pure endoscopic clipping of anterior circulation aneurysms through keyhole approach

Tang,

Niu,

Zheng

et al. 2024

Preprint

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“…1 The technique of using the endoscope for vascular approaches has been called endoscope-assisted microneurosurgery, which has been useful from direct clipping procedures in endonasal approaches, clip revisions, clip replacement, search for perforating branches, and even revision of the aneurysm once clipped, reporting a very low rate of complications associated with its use. 2 3 4 Direct clipping using only the endoscope is rare, so until now its use has been limited to checking the clip once it is in place and the shape of the aneurysm in relation to its perforating branches. 5 Certainly, and despite its greater routine use in operating rooms, very little attention has been paid to reviewing and characterizing aneurysm domes, as well as their morphology, which is especially important since these characteristics inform us about trans-surgical risk of rupture, previous ruptures, or difficulty during clipping.…”

Section: Introductionmentioning

confidence: 99%

Dual Microscope Indocyanine Green Video Angiography and Endoscopic Review to Treat Intracranial Aneurysm: A Review of the Literature Regarding a Case

Vega-Moreno,

Janković,

Azouz

et al. 2023

Asian J Neurosurg

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The use of the indocyanine green video angiography (ICG-VA) both endoscope and microscope has become popular in recent decades thanks to the safety, efficacy, and added value that they have provided for cerebrovascular surgery. The dual use of these technologies is considered complementary and has helped cerebrovascular surgeons in decision-making, especially for aneurysm clipping surgery; however, its use has been described for both aneurysm surgery, resection of arteriovenous malformations, or even for bypass surgeries. We conducted a review of the literature with the MeSH terms “microscope indocyanine green video angiography (mICG-VA),” “endoscopic review,” AND/OR “intracranial aneurysm.” A total of 97 articles that included these terms were selected after a primary review to select a total of 26 articles for the final review. We also present a case to exemplify its use, in which we use both technological tools for the description of the aneurysm, as well as for decision-making at the time of clipping and for reclipping. Both tools, both the use of the endoscope and the mICG-VA, have helped decision-making in neurovascular surgery. A considerable clip replacement rate has been described with the use of these technologies, which has helped to reduce the complications associated with poor clipping. One of the main advantages of their usefulness is that they are tools for intraoperative use, which is why they have shown superiority compared to digital subtraction angiography, which takes longer to use and has a higher risk of complications associated with the contrast medium. On the other hand, a very low rate of complications has been described with the use of the endoscope and mICG-VA, which is why they are considered safe tools to use. In some cases, mention has been made of the use of one or the other technology; however, we consider that its dual use provides more information about the status of the clip, its anatomy, its relationship with other vascular structures, and the complete occlusion of the aneurysm. We consider that the use of both technologies is complementary, so in case of having them both should be used, since both the endoscope and the mICG-VA provide additional and useful information.

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“…1 The technique of using the endoscope for vascular approaches has been called endoscope-assisted microneurosurgery, which has been useful from direct clipping procedures in endonasal approaches, clip revisions, clip replacement, search for perforating branches, and even revision of the aneurysm once clipped, reporting a very low rate of complications associated with its use. [2][3][4] Direct clipping using only the endoscope is rare, so until now its use has been limited to checking the clip once it is in place and the shape of the aneurysm in relation to its perforating branches. 5 Certainly, and despite its greater routine use in operating rooms, very little attention has been paid to reviewing and characterizing aneurysm domes, as well as their morphology, which is especially important since these characteristics inform us about trans-surgical risk of rupture, previous ruptures, or difficulty during clipping.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2023

Asian J Neurosurg

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The use of the indocyanine green video angiography (ICG-VA) both endoscope and microscope has become popular in recent decades thanks to the safety, efficacy, and added value that they have provided for cerebrovascular surgery. The dual use of these technologies is considered complementary and has helped cerebrovascular surgeons in decision-making, especially for aneurysm clipping surgery; however, its use has been described for both aneurysm surgery, resection of arteriovenous malformations, or even for bypass surgeries. We conducted a review of the literature with the MeSH terms "microscope indocyanine green video angiography (mICG-VA)," "endoscopic review," AND/OR "intracranial aneurysm." A total of 97 articles that included these terms were selected after a primary review to select a total of 26 articles for the final review. We also present a case to exemplify its use, in which we use both technological tools for the description of the aneurysm, as well as for decision-making at the time of clipping and for reclipping. Both tools, both the use of the endoscope and the mICG-VA, have helped decision-making in neurovascular surgery. A considerable clip replacement rate has been described with the use of these technologies, which has helped to reduce the complications associated with poor clipping. One of the main advantages of their usefulness is that they are tools for intraoperative use, which is why they have shown superiority compared to digital subtraction angiography, which takes longer to use and has a higher risk of complications associated with the contrast medium. On the other hand, a very low rate of complications has been described with the use of the endoscope and mICG-VA, which is why they are considered safe tools to use. In some cases, mention has been made of the use of one or the other technology;

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Endoscope-assisted microneurosurgery for intracranial aneurysms: A systematic review and meta-analysis

Cited by 5 publications

References 37 publications

Pure endoscopic clipping of anterior circulation aneurysms through keyhole approach

Pure endoscopic clipping of anterior circulation aneurysms through keyhole approach

Dual Microscope Indocyanine Green Video Angiography and Endoscopic Review to Treat Intracranial Aneurysm: A Review of the Literature Regarding a Case

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