A comparative analysis of the endoscopic endonasal and pterional approaches for clipping anterior communicating artery aneurysms on three-dimensional printed models

Anterior communicating artery(ACoA)aneurysms account for the largest proportion of intracranial aneurysms and are the most likely to rupture.[1]The main treatment methods are endovascular embolization and traditional craniotomy clipping.[2]With the rapid development of interventional materials and technologies in the last two decades,many medical centers have adopted endovascular embolization as the preferred treatment for intracranial aneurysms.However,some aneurysms still require traditional craniotomy clipping.Transsphenoidal endoscopy technology has also developed rapidly in recent years.[3]Because intracranial aneurysms are mostly within the circle of Willis and occur on the ventral side of the skull base,a few neurosurgeons have tried to use an endoscopic endonasal approach(EEA)for clipping.[4-6]However,the number of cases reported in the literature is small and more anatomical studies are needed to deeply analyze the approach and technique.