{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:31:22Z","timestamp":1769725882641,"version":"3.49.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"22","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"\n BACKGROUND<\/jats:title>\n Intracranial anastomotic aneurysms (IAAs) are rare and often challenging to treat. While endovascular treatments for IAAs have been documented in the literature, no prior reports exist on the use of high-flow bypass surgery (HFBS) as a rescue treatment for IAAs. Here, the authors present the first successful case of HFBS for IAAs.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 45-year-old woman presenting with persistent dizziness was diagnosed with a large right middle cerebral artery (MCA) aneurysm. She underwent HFBS using a radial artery (RA) graft through an external carotid artery (ECA)\u2013RA-MCA bypass, combined with aneurysm molding and proximal MCA clipping. One year postoperatively, a de novo aneurysm developed at the anastomotic site. The recurrent aneurysm was successfully treated with clipping and remolding, followed by MCA reconstruction with HFBS using an RA graft via ECA-RA-RA-MCA bypass. The postoperative course remained uneventful, with no evidence of aneurysm recurrence during 1 year of follow-up after the second procedure.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n IAAs may develop following bypass procedures, underscoring the importance of rigorous postoperative surveillance. The authors demonstrate that HBFS represents a viable alternative approach for this complication, with satisfactory clinical outcomes in their case. These findings suggest that HFBS may potentially emerge as a novel therapeutic option for IAAs.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25656<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25656","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:11:24Z","timestamp":1769685084000},"source":"Crossref","is-referenced-by-count":0,"title":["Repeat high-flow bypass surgery for rescue of anastomotic aneurysm formation after external carotid artery\u2013to\u2013middle cerebral artery bypass: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Hanhai","family":"Zeng","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China"},{"name":"Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shenglong","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China"},{"name":"Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hangzhe","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China"},{"name":"Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China"},{"name":"Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6449-4930","authenticated-orcid":true,"given":"Lin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang Province, China"},{"name":"Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"bib1","series-title":"Neurol India","first-page":"1741","article-title":"Surgery for very large and giant intracranial aneurysms: results and complications","volume":"66","author":"Zeeshan","year":"2018","unstructured":"Zeeshan QGhodke BVJuric-Sekhar GBarber JKKim LJSekhar LN.Surgery for very large and giant intracranial aneurysms: results and complications. Neurol India. 2018;66(6):1741-1757."},{"key":"bib2","series-title":"Trends in Cerebrovascular Surgery and Interventions","first-page":"19","article-title":"Current strategies in the treatment of intracranial large and giant aneurysms","author":"Gmeiner","year":"2021","unstructured":"Gmeiner MGruber A.Current strategies in the treatment of intracranial large and giant aneurysms. In: Esposito G, Regli L, Cenzato M, et al., eds. Trends in Cerebrovascular Surgery and Interventions. Springer; 2021:19-26."},{"issue":"3","key":"bib3","series-title":"Asian J Neurosurg","first-page":"382","article-title":"Surgical treatment of large and giant cavernous carotid aneurysms","volume":"12","author":"Sriamornrattanakul","year":"2017","unstructured":"Sriamornrattanakul KSakarunchai IYamashiro KSurgical treatment of large and giant cavernous carotid aneurysms. Asian J Neurosurg. 2017;12(3):382-388."},{"issue":"6","key":"bib4","series-title":"Oper Neurosurg","first-page":"e382","article-title":"Superficial temporal artery to the middle cerebral artery anastomotic aneurysm treated with an endovascular approach: a case report","volume":"23","author":"Benalia","year":"2022","unstructured":"Benalia VHCCortez GMAghaebrahim AHanel RASauvageau E.Superficial temporal artery to the middle cerebral artery anastomotic aneurysm treated with an endovascular approach: a case report. Oper Neurosurg. 2022;23(6):e382-e386."},{"issue":"4","key":"bib5","series-title":"NMC Case Rep J","first-page":"111","article-title":"Anastomotic aneurysm formation after high flow bypass surgery: a case report with histopathological study","volume":"4","author":"Uchida","year":"2017","unstructured":"Uchida TYoshino MIto SHara T.Anastomotic aneurysm formation after high flow bypass surgery: a case report with histopathological study. NMC Case Rep J. 2017;4(4):111-113."},{"issue":"5","key":"bib6","series-title":"J Neurosurg Pediatr","first-page":"572","article-title":"Endovascular stenting for rescue of a failed donor graft during superficial temporal artery to middle cerebral artery bypass surgery: case report","volume":"24","author":"LoPresti","year":"2019","unstructured":"LoPresti MASrinivasan VMNorth RYEndovascular stenting for rescue of a failed donor graft during superficial temporal artery to middle cerebral artery bypass surgery: case report. J Neurosurg Pediatr. 2019;24(5):572-576."},{"key":"bib7","series-title":"World Neurosurg","first-page":"e272","article-title":"Brain bypass surgery for complex middle cerebral artery aneurysms: evolving techniques, results, and lessons learned","volume":"130","author":"Natarajan","year":"2019","unstructured":"Natarajan SKZeeshan QGhodke BVSekhar LN.Brain bypass surgery for complex middle cerebral artery aneurysms: evolving techniques, results, and lessons learned. 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J Neurosurg Pediatr. 2019;24(5):572-576."},{"key":"bib7","series-title":"World Neurosurg","first-page":"e272","article-title":"Brain bypass surgery for complex middle cerebral artery aneurysms: evolving techniques, results, and lessons learned","volume":"130","author":"Natarajan","year":"2019","unstructured":"Natarajan SKZeeshan QGhodke BVSekhar LN.Brain bypass surgery for complex middle cerebral artery aneurysms: evolving techniques, results, and lessons learned. World Neurosurg. 2019;130:e272-e293."},{"issue":"4","key":"bib8","series-title":"Pol Przegl Chir","first-page":"181","article-title":"Anastomotic aneurysms\u201420-years of experience from one center","volume":"85","author":"Pogorzelski","year":"2013","unstructured":"Pogorzelski RFiszer PToutounchi SAnastomotic aneurysms\u201420-years of experience from one center. Pol Przegl Chir. 2013;85(4):181-191."},{"issue":"3","key":"bib9","series-title":"Surgery","first-page":"509","article-title":"Pathogenesis of anastomotic aneurysms","volume":"90","author":"Gaylis","year":"1981","unstructured":"Gaylis H.Pathogenesis of anastomotic aneurysms. Surgery. 1981;90(3):509-515."},{"issue":"1","key":"bib10","series-title":"J Clin Neurosci","first-page":"1","article-title":"High flow extracranial-to-intracranial brain bypass surgery","volume":"20","author":"Sia","year":"2013","unstructured":"Sia SFMorgan MK.High flow extracranial-to-intracranial brain bypass surgery. J Clin Neurosci. 2013;20(1):1-5."},{"issue":"1","key":"bib11","series-title":"J Neurosurg","first-page":"80","article-title":"Long-term patency in cerebral revascularization surgery: an analysis of a consecutive series of 430 bypasses","volume":"131","author":"Yoon","year":"2019","unstructured":"Yoon SBurkhardt JKLawton MT.Long-term patency in cerebral revascularization surgery: an analysis of a consecutive series of 430 bypasses. J Neurosurg. 2019;131(1):80-87."},{"issue":"2","key":"bib12","series-title":"Neurosurg Focus","first-page":"E14","article-title":"Flow-based evaluation of cerebral revascularization using near-infrared indocyanine green videoangiography","volume":"36","author":"Januszewski","year":"2014","unstructured":"Januszewski JBeecher JSChalif DJDehdashti AR.Flow-based evaluation of cerebral revascularization using near-infrared indocyanine green videoangiography. 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