Abstract：
It is necessary to secure both the proximal and distal sides of the parent artery to prevent premature rupture when clipping cerebral aneurysms. Herein, we describe four cases in which the proximal internal carotid artery (ICA), affected by a paraclinoid aneurysm, was secured using an endoscopic endonasal approach. We used various tools, including a surgical video, cadaver dissection picture, artist\'s illustration, and intraoperative photographs, to elucidate the process. No patient experienced postoperative complications at our institution. Compared to the cervical or cavernous ICA, the ICA adjacent to the clivus (paraclival ICA) can be anatomically safely and easily exposed using an endoscopic endonasal approach because there is no need to consider cerebrospinal fluid leakage or hemorrhage from the cavernous sinus. Securing the proximal side of the parent artery using an endoscopic endonasal approach may be a viable method for clipping selected ICA aneurysms, such as paraclinoid aneurysms especially for upward or outward aneurysms of the C2 portion.
摘要：
有必要固定父动脉的近侧和远侧，以防止夹闭脑动脉瘤时过早破裂。在这里，我们描述了4例，其中近端颈内动脉（ICA），受突旁动脉瘤影响,使用鼻内镜入路固定。我们使用了各种工具，包括一段手术录像,尸体解剖图片,艺术家的插图，术中照片，来阐明这个过程。我们机构没有患者出现术后并发症。与宫颈或海绵状ICA相比，由于无需考虑海绵窦的脑脊液漏或出血,因此可以使用内窥镜经鼻入路在解剖学上安全且容易地暴露与斜坡相邻的ICA(ParaclivalICA).使用内镜经鼻入路固定母体动脉的近侧可能是夹闭选定ICA动脉瘤的可行方法。例如，尤其是C2部分的向上或向外动脉瘤。
