Clinical studies have suggested the endoscopic endonasal approach (EEA) for aneurysm clipping as a feasible way to treat select intracranial aneurysms. Among neurosurgery, there is not a consensus on the utility of EEA aneurysm clipping. This review aims to define the anatomic feasibility of EEA for aneurysm clipping. Two databases (PubMed, Cochrane) were searched for anatomical studies assessing EEA for intracranial aneurysm clipping. Literature review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Quantitative anatomical studies were included. Eleven studies met inclusion criteria. Vascular exposure and clip placement on vessels of interest were possible, although only one study assessed these parameters with physical aneurysm models. Anterior circulation vessels, although accessible in over 90% of specimens, had low successful clipping rates in a small and large aneurysm models. Small and large model posterior circulation aneurysms were more readily clipped. Proximal and distal controls were readily attainable in posterior circulation aneurysms, but not anterior. This current literature review highlights the relevance of anatomical studies in assessing the feasibility of the EEA for clipping intracranial aneurysms. As such, anterior circulation aneurysms are poor candidates for EEA given difficulties in clip placement and obtaining proximal control and distal control in small and large aneurysms. While our results suggest that clipping of posterior circulation aneurysms is feasible from a technical stand of view, further clinical experience is required to assess its feasibility in terms of safety and efficacy, balancing the indications with endovascular treatment options.

临床研究表明，用于动脉瘤夹闭的内窥镜鼻内入路 (EEA) 是治疗特定颅内动脉瘤的可行方法。在神经外科中，对 EEA 动脉瘤夹闭的效用没有达成共识。本综述旨在确定 EEA 用于动脉瘤夹闭的解剖学可行性。搜索了两个数据库（PubMed、Cochrane）以寻找评估 EEA 颅内动脉瘤夹闭的解剖学研究。文献回顾是根据 PRISMA（系统评价和元分析的首选报告项目）指南进行的。包括定量解剖学研究。11 项研究符合纳入标准。血管暴露和夹子放置在感兴趣的血管上是可能的，尽管只有一项研究使用物理动脉瘤模型评估了这些参数。前循环血管，尽管在超过 90% 的标本中都可以使用，但在小型和大型动脉瘤模型中的成功夹闭率较低。小型和大型模型后循环动脉瘤更容易被夹住。在后循环动脉瘤中很容易获得近端和远端控制，但不是前部。目前的文献综述强调了解剖学研究在评估 EEA 夹闭颅内动脉瘤的可行性方面的相关性。因此，考虑到夹子放置以及在大小动脉瘤中获得近端控制和远端控制方面的困难，前循环动脉瘤不适合 EEA。虽然我们的结果表明从技术角度来看后循环动脉瘤的夹闭是可行的，