{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:15:38Z","timestamp":1779884138616,"version":"3.53.1"},"reference-count":19,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Introduction: Aneurysms of brain vessels are life-threatening conditions with various adverse outcomes, some stemming from microsurgical intervention, particularly when major vessel perforators are inadequately protected. The use of endoscopes enhances the approach to aneurysms by providing closer visualization (180\u2013360 degrees) of the local anatomy, potentially reducing accidental damage. To improve visualization and efficiency, a microscope-integrated 45-degree angled microinspection endoscopic tool (QEVO\u00ae, Carl Zeiss, OberkochenTM) has been developed and employed in various neurosurgical procedures. Methods: Between 2021 and 2025, 27 brain aneurysms were treated with QEVO\u00ae assistance at the Department of Neurosurgery, Clinical Center of the University of Sarajevo. The choice of the videos corresponds to the best image quality in videos and on the microscopic determination of adjacent vessel perforators, which were not adequately seen purely by the surgical microscope in specific cases. Exclusion criteria included cases without a need for QEVO\u00ae assistance in perforator visualization, severe brain edema, intraoperative aneurysm rupture, posterior circulation, or low video quality. Results: Case 1 demonstrates an anterior choroidal artery (AchA) aneurysm; Case 2 presents an anterior communicating artery (AcommA) aneurysm; and Case 3 features contralateral middle cerebral artery (MCA) microsurgical clipping with QEVO\u00ae assistance. Conclusions: The QEVO\u00ae tool significantly improves the visualization of aneurysm\u2013perforator relationships, increasing the likelihood of preserving perforators during standard microsurgical clipping. This innovative approach may reduce surgical complications and enhance patient outcomes, highlighting the tool\u2019s potential as an adjunct in aneurysm microsurgery.<\/jats:p>","DOI":"10.3390\/brainsci15030300","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T10:45:06Z","timestamp":1741776306000},"page":"300","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["QEVO\u00ae-Assisted Anatomical Inspection of Adjacent Perforators in Microsurgical Clipping\u2014Technical Note"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1599-1807","authenticated-orcid":false,"given":"Adi","family":"Ahmetspahic","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Center of University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina"},{"name":"Department of Medicine, University Sarajevo School of Science and Technology, 71000 Sarajevo, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eldin","family":"Burazerovic","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Center of University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Rizvanovic","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Sarajevo School of Science and Technology, 71000 Sarajevo, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4548-3653","authenticated-orcid":false,"given":"Ema","family":"Selimovic","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Sarajevo School of Science and Technology, 71000 Sarajevo, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Kujaca","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Sarajevo School of Science and Technology, 71000 Sarajevo, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6123-5589","authenticated-orcid":false,"given":"Mirza","family":"Pojskic","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Philipps University of Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Feletti","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Biomedicine, and Movement Sciences, Institute of Neurosurgery, University of Verona, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3745-288X","authenticated-orcid":false,"given":"Kenan","family":"Arnautovic","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis, TN 38138, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"686","DOI":"10.4103\/ajns.AJNS_131_17","article-title":"Review of Avoidance of Complications in Cerebral Aneurysm Surgery: The Fujita Experience","volume":"14","author":"Ansari","year":"2019","journal-title":"Asian J. 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