Objective: To explore the operative technique and evaluate the effect of intracranial aneurysms via keyhole approach.

Methods: Fifty-six intracranial aneurysm patients, 23 with anterior communicating artery (AcomA) aneurysm, 29 with posterior communicating artery (PcomA) aneurysm, and 4 with internal carotid artery-posterior communicating artery aneurysm, totally with 58 lesions, were treated by microsurgery, via supraorbital keyhole approach in 22 cases, pterional approach in 18, and transorbital approach in 16. Adjuvant endoscopy was used in 33 patients.

Results: Fifty-eight lesions of aneurysm were clipped in all the patients and no one died. No approach-related severe complication occurred. Bilateral PcomA aneurysms in 2 cases were clipped via unilateral keyhole approach.

Conclusion: It is workable to treat intracranial aneurysms via keyhole approach. Keyhole approach not only reduces the operation-related trauma and shorten the operation time, but also obtains ideal results.

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