{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T13:03:52Z","timestamp":1772715832666,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ruptured intracranial aneurysms remain a formidable challenge in neurosurgery. This study presents our initial experience with fully endoscopic bimanual clipping for ruptured aneurysms and aims to evaluate its safety and feasibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective single-center study, patients with ruptured aneurysms scheduled for clipping underwent surgery exclusively via fully endoscopic bimanual techniques. The data collected included patient records, radiological images, aneurysm characteristics, surgical details, and postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From January 2022 to April 2025, eight consecutive patients with ruptured aneurysms (two women and six men, with a mean age of 64.1\u202f\u00b1\u202f10.2\u202fyears) underwent fully endoscopic clipping. Aneurysm locations included the middle cerebral artery (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f1), posterior communicating artery (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f1), anterior communicating artery (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f3), anterior cerebral artery (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f2), and ophthalmic artery (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f1). No intraprocedural rupture occurred. Endoscopic inspection and postoperative computed tomography angiography confirmed complete aneurysm occlusion with preservation of all parent and perforating vessels in all cases. No postoperative cerebral infarctions attributable to vessel compromise were observed. No mortality related to the endoscopic procedure was observed. During follow-up ranging from 1 to 28\u202fmonths, seven patients (87.5%) achieved excellent or good recovery (Karnofsky Performance Status [KPS]\u202f\u2265\u202f80), and one patient showed improved KPS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fully endoscopic bimanual clipping for ruptured aneurysms is safe and feasible. This technique provides enhanced visual information for intraoperative decision-making while minimizing unnecessary tissue manipulation and retraction. Accumulating experience suggests that this technique holds promise for further improving the quality of surgical care for ruptured aneurysms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1705373","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T12:05:33Z","timestamp":1772712333000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Transcranial fully endoscopic clipping techniques for ruptured aneurysms: an initial experience from a single center"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhengxing","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]},{"name":"Neuro-Endoscope and Mini-Invasive Treatment Center, The Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengyang","family":"Xie","sequence":"additional","affiliation":[{"name":"Jiamusi University","place":["Jiamusi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]},{"name":"Neuro-Endoscope and Mini-Invasive Treatment Center, The Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jieping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]},{"name":"Neuro-Endoscope and Mini-Invasive Treatment Center, The Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1970","DOI":"10.1016\/j.mayocp.2021.01.005","article-title":"Diagnosis and treatment of unruptured intracranial aneurysms and aneurysmal subarachnoid Hemorrhage","volume":"96","author":"Tawk","year":"2021","journal-title":"Mayo Clin Proc"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1007\/s00701-024-06262-0","article-title":"Outcomes and predictors of intraprocedural rupture in patients with cerebral aneurysm","volume":"166","author":"Kim","year":"2024","journal-title":"Acta Neurochir"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1007\/s00701-024-06064-4","article-title":"Changes in treatment of intracranial aneurysms during the last decade in a large European neurovascular 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