{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:37:19Z","timestamp":1769726239669,"version":"3.49.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"24","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"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":[[2025,12,15]]},"abstract":"\n BACKGROUND<\/jats:title>\n Common carotid artery (CCA)\u2013subclavian artery bypass is performed for CCA occlusive disease. Reported complications include infection, occlusion, anastomotic leakage, and nerve injury. A pseudoaneurysm at the anastomotic site is rare, and most develop within 1\u20132 years after the procedure. The authors present a case of an anastomotic pseudoaneurysm occurring 50 years after bypass surgery.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 76-year-old woman presented with progressive neck swelling. She had undergone left CCA\u2013subclavian artery bypass 50 years earlier. Imaging revealed a pseudoaneurysm, with occlusion of both the left CCA and the graft. The distal CCA was opacified via retrograde flow through an extracranial-intracranial anastomosis from the right internal carotid artery (ICA). The aneurysm was thought to be supplied solely by this. Ligation of the ICA\u2013external carotid artery bifurcation was planned. Intraoperatively, however, several microvessels resembling the vasa vasorum were found entering and supplying the pseudoaneurysm. Trapping and excision were achieved by dividing them. Pathological analysis showed a fibrous aneurysm wall containing remnants of the vascular prosthesis, with immune cell infiltration, phagocytosis, and surrounding microvessels.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Anastomotic pseudoaneurysm may occur decades after CCA\u2013subclavian artery bypass. This case underscores that prosthetic grafts require lifelong surveillance, as delayed complications may result from long-term graft degeneration, chronic inflammation, or occult infection.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25704<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25704","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T11:59:49Z","timestamp":1769083189000},"source":"Crossref","is-referenced-by-count":0,"title":["Anastomotic pseudoaneurysm presenting 50 years after common carotid artery\u2013subclavian artery bypass: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Mayuko","family":"Otomo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Saitama Red Cross Hospital, Saitama"},{"name":"Department of Neurosurgery, Tohoku University Graduate School of Medicine, Miyagi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5131-4307","authenticated-orcid":true,"given":"Tomoo","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saitama Red Cross Hospital, Saitama"},{"name":"Department of Neurosurgery, Tohoku University Graduate School of Medicine, Miyagi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0139-1322","authenticated-orcid":true,"given":"Nobuo","family":"Noshita","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saitama Red Cross Hospital, Saitama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshie","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saitama Red Cross Hospital, Saitama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Department of Pathology, Saitama Red Cross Hospital, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1472-6032","authenticated-orcid":true,"given":"Hidenori","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tohoku University Graduate School of Medicine, Miyagi"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"9","key":"bib1","series-title":"Stroke","first-page":"1565","article-title":"Carotid-subclavian bypass for brachiocephalic occlusive disease. Choice of conduit and long-term follow-up","volume":"26","author":"Law","year":"1995","unstructured":"Law MMColburn MDMoore WSQui\u00f1ones-Baldrich WJMachleder HIGelabert HA.Carotid-subclavian bypass for brachiocephalic occlusive disease. Choice of conduit and long-term follow-up. Stroke. 1995;26(9):1565-1571."},{"issue":"1","key":"bib2","series-title":"Br J Surg","first-page":"7","article-title":"Choice of material for above-knee femoropopliteal bypass graft","volume":"76","author":"Michaels","year":"1989","unstructured":"Michaels JA.Choice of material for above-knee femoropopliteal bypass graft. Br J Surg. 1989;76(1):7-14."},{"issue":"12","key":"bib3","series-title":"Am Surg","first-page":"818","article-title":"Pseudoaneurysms of the aorta after cardiac surgery or chest trauma","volume":"59","author":"Razzouk","year":"1993","unstructured":"Razzouk AGundry SWang NPseudoaneurysms of the aorta after cardiac surgery or chest trauma. Am Surg. 1993;59(12):818-823."},{"issue":"11","key":"bib4","series-title":"BMJ Case Rep","first-page":"e240157","article-title":"Spontaneous graft pseudoaneurysm presenting a decade after carotid-subclavian bypass: an extremely rare complication detected on CT","volume":"13","author":"Ojha","year":"2020","unstructured":"Ojha VVerma MChandrashekhara SHKumar S.Spontaneous graft pseudoaneurysm presenting a decade after carotid-subclavian bypass: an extremely rare complication detected on CT. BMJ Case Rep. 2020;13(11):e240157."},{"issue":"1","key":"bib5","series-title":"Vasc Endovasc Surg","first-page":"57","article-title":"Traumatic nonanastomotic pseudoaneurysm of axillofemoral bypass graft: a case report and review of the literature","volume":"47","author":"Mousa","year":"2013","unstructured":"Mousa AYNanjundappa AAbu-Halimah SAburahma AF.Traumatic nonanastomotic pseudoaneurysm of axillofemoral bypass graft: a case report and review of the literature. Vasc Endovasc Surg. 2013;47(1):57-60."},{"issue":"7","key":"bib6","series-title":"Jpn J Vasc Surg","first-page":"976","article-title":"A case of recurrent femoral anastomotic pseudoaneurysm that developed 3 years after femoro-popliteal bypass surgery","volume":"22","author":"Thsuchida","year":"2013","unstructured":"Thsuchida HKoizumi NTakahashi S.A case of recurrent femoral anastomotic pseudoaneurysm that developed 3 years after femoro-popliteal bypass surgery. Jpn J Vasc Surg. 2013;22(7):976-979."},{"key":"bib7","series-title":"Front Radiol","first-page":"1327050","article-title":"Case report: false aneurysm as a late unusual complication of the aortofemoral bypass graft in a patient with critical leg ischemic symptoms: interesting case","volume":"4","author":"Belfiore","year":"2024","unstructured":"Belfiore MPZeccolini RRoccatagliata PGallo LFabozzi ACappabianca S.Case report: false aneurysm as a late unusual complication of the aortofemoral bypass graft in a patient with critical leg ischemic symptoms: interesting case. Front Radiol. 2024;4:1327050."},{"issue":"5","key":"bib8","series-title":"Ann Thorac Cardiovasc Surg","first-page":"485","article-title":"Late-stage non-anastomotic rupture of axillo-bifemoral bypass graft","volume":"18","author":"Shiraishi","year":"2012","unstructured":"Shiraishi MKimura CTakeuchi TMuramatsu K.Late-stage non-anastomotic rupture of axillo-bifemoral bypass graft. Ann Thorac Cardiovasc Surg. 2012;18(5):485-487."},{"key":"bib9","series-title":"JTCVS Tech","first-page":"259","article-title":"Repair of extra-anatomic bypass graft structural degeneration and pseudoaneurysm with endovascular stent-graft relining","volume":"3","author":"Stephens","year":"2020","unstructured":"Stephens EHFleischmann DStarr AMiller DC.Repair of extra-anatomic bypass graft structural degeneration and pseudoaneurysm with endovascular stent-graft relining. JTCVS Tech. 2020;3:259-262."},{"issue":"6","key":"bib10","series-title":"Neurosurg Rev","first-page":"1565","article-title":"Inflammation promotes progression of thrombi in intracranial thrombotic aneurysms","volume":"43","author":"Suzuki","year":"2020","unstructured":"Suzuki HMikami TTamada TInflammation promotes progression of thrombi in intracranial thrombotic aneurysms. Neurosurg Rev. 2020;43(6):1565-1573."},{"issue":"1","key":"bib11","series-title":"Ann Surg","first-page":"35","article-title":"Bacterial adherence to surgical sutures. A possible factor in suture induced infection","volume":"194","author":"Katz","year":"1981","unstructured":"Katz SIzhar MMirelman D.Bacterial adherence to surgical sutures. A possible factor in suture induced infection. Ann Surg. 1981;194(1):35-41."},{"issue":"3","key":"bib12","series-title":"Glob Spine J","first-page":"254","article-title":"Patterns of cervical disc degeneration: analysis of magnetic resonance imaging of over 1000 symptomatic subjects","volume":"8","author":"Suzuki","year":"2017","unstructured":"Suzuki ADaubs MDHayashi TPatterns of cervical disc degeneration: analysis of magnetic resonance imaging of over 1000 symptomatic subjects. Glob Spine J. 2017;8(3):254-259."},{"key":"bib13","series-title":"World Neurosurg","first-page":"e776","article-title":"Degenerative cervical disc herniation: prevalence of affected cervical level in a Hispanic population in Puerto Rico","volume":"181","author":"De Jesus","year":"2024","unstructured":"De Jesus OD.Degenerative cervical disc herniation: prevalence of affected cervical level in a Hispanic population in Puerto Rico. World Neurosurg. 2024;181:e776-e779."},{"issue":"9","key":"bib1","series-title":"Stroke","first-page":"1565","article-title":"Carotid-subclavian bypass for brachiocephalic occlusive disease. Choice of conduit and long-term follow-up","volume":"26","author":"Law","year":"1995","unstructured":"Law MMColburn MDMoore WSQui\u00f1ones-Baldrich WJMachleder HIGelabert HA.Carotid-subclavian bypass for brachiocephalic occlusive disease. Choice of conduit and long-term follow-up. Stroke. 1995;26(9):1565-1571."},{"issue":"1","key":"bib2","series-title":"Br J Surg","first-page":"7","article-title":"Choice of material for above-knee femoropopliteal bypass graft","volume":"76","author":"Michaels","year":"1989","unstructured":"Michaels JA.Choice of material for above-knee femoropopliteal bypass graft. Br J Surg. 1989;76(1):7-14."},{"issue":"12","key":"bib3","series-title":"Am Surg","first-page":"818","article-title":"Pseudoaneurysms of the aorta after cardiac surgery or chest trauma","volume":"59","author":"Razzouk","year":"1993","unstructured":"Razzouk AGundry SWang NPseudoaneurysms of the aorta after cardiac surgery or chest trauma. Am Surg. 1993;59(12):818-823."},{"issue":"11","key":"bib4","series-title":"BMJ Case Rep","first-page":"e240157","article-title":"Spontaneous graft pseudoaneurysm presenting a decade after carotid-subclavian bypass: an extremely rare complication detected on CT","volume":"13","author":"Ojha","year":"2020","unstructured":"Ojha VVerma MChandrashekhara SHKumar S.Spontaneous graft pseudoaneurysm presenting a decade after carotid-subclavian bypass: an extremely rare complication detected on CT. BMJ Case Rep. 2020;13(11):e240157."},{"issue":"1","key":"bib5","series-title":"Vasc Endovasc Surg","first-page":"57","article-title":"Traumatic nonanastomotic pseudoaneurysm of axillofemoral bypass graft: a case report and review of the literature","volume":"47","author":"Mousa","year":"2013","unstructured":"Mousa AYNanjundappa AAbu-Halimah SAburahma AF.Traumatic nonanastomotic pseudoaneurysm of axillofemoral bypass graft: a case report and review of the literature. Vasc Endovasc Surg. 2013;47(1):57-60."},{"issue":"7","key":"bib6","series-title":"Jpn J Vasc Surg","first-page":"976","article-title":"A case of recurrent femoral anastomotic pseudoaneurysm that developed 3 years after femoro-popliteal bypass surgery","volume":"22","author":"Thsuchida","year":"2013","unstructured":"Thsuchida HKoizumi NTakahashi S.A case of recurrent femoral anastomotic pseudoaneurysm that developed 3 years after femoro-popliteal bypass surgery. Jpn J Vasc Surg. 2013;22(7):976-979."},{"key":"bib7","series-title":"Front Radiol","first-page":"1327050","article-title":"Case report: false aneurysm as a late unusual complication of the aortofemoral bypass graft in a patient with critical leg ischemic symptoms: interesting case","volume":"4","author":"Belfiore","year":"2024","unstructured":"Belfiore MPZeccolini RRoccatagliata PGallo LFabozzi ACappabianca S.Case report: false aneurysm as a late unusual complication of the aortofemoral bypass graft in a patient with critical leg ischemic symptoms: interesting case. Front Radiol. 2024;4:1327050."},{"issue":"5","key":"bib8","series-title":"Ann Thorac Cardiovasc Surg","first-page":"485","article-title":"Late-stage non-anastomotic rupture of axillo-bifemoral bypass graft","volume":"18","author":"Shiraishi","year":"2012","unstructured":"Shiraishi MKimura CTakeuchi TMuramatsu K.Late-stage non-anastomotic rupture of axillo-bifemoral bypass graft. Ann Thorac Cardiovasc Surg. 2012;18(5):485-487."},{"key":"bib9","series-title":"JTCVS Tech","first-page":"259","article-title":"Repair of extra-anatomic bypass graft structural degeneration and pseudoaneurysm with endovascular stent-graft relining","volume":"3","author":"Stephens","year":"2020","unstructured":"Stephens EHFleischmann DStarr AMiller DC.Repair of extra-anatomic bypass graft structural degeneration and pseudoaneurysm with endovascular stent-graft relining. JTCVS Tech. 2020;3:259-262."},{"issue":"6","key":"bib10","series-title":"Neurosurg Rev","first-page":"1565","article-title":"Inflammation promotes progression of thrombi in intracranial thrombotic aneurysms","volume":"43","author":"Suzuki","year":"2020","unstructured":"Suzuki HMikami TTamada TInflammation promotes progression of thrombi in intracranial thrombotic aneurysms. Neurosurg Rev. 2020;43(6):1565-1573."},{"issue":"1","key":"bib11","series-title":"Ann Surg","first-page":"35","article-title":"Bacterial adherence to surgical sutures. A possible factor in suture induced infection","volume":"194","author":"Katz","year":"1981","unstructured":"Katz SIzhar MMirelman D.Bacterial adherence to surgical sutures. A possible factor in suture induced infection. Ann Surg. 1981;194(1):35-41."},{"issue":"3","key":"bib12","series-title":"Glob Spine J","first-page":"254","article-title":"Patterns of cervical disc degeneration: analysis of magnetic resonance imaging of over 1000 symptomatic subjects","volume":"8","author":"Suzuki","year":"2017","unstructured":"Suzuki ADaubs MDHayashi TPatterns of cervical disc degeneration: analysis of magnetic resonance imaging of over 1000 symptomatic subjects. Glob Spine J. 2017;8(3):254-259."},{"key":"bib13","series-title":"World Neurosurg","first-page":"e776","article-title":"Degenerative cervical disc herniation: prevalence of affected cervical level in a Hispanic population in Puerto Rico","volume":"181","author":"De Jesus","year":"2024","unstructured":"De Jesus OD.Degenerative cervical disc herniation: prevalence of affected cervical level in a Hispanic population in Puerto Rico. World Neurosurg. 2024;181:e776-e779."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/24\/article-CASE25704.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/24\/article-CASE25704.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/24\/article-CASE25704.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:12:42Z","timestamp":1769685162000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/24\/article-CASE25704.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,15]]},"references-count":26,"journal-issue":{"issue":"24"},"URL":"https:\/\/doi.org\/10.3171\/case25704","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,15]]}}}