Endoscopic endonasal clipping of a medial paraclinoid aneurysm with roadmapping assistance: Two-dimensional operative video.

ABSTRACT

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.