Alibraheemi Mohammed Q, Alhadeethi Bandar M, Nissar Sheikh Ozair, Al-Ghuraibawi Mohammedbaqer Ali, Muthana Ahmed, Hoz Samer S
Department of Neurosurgery, University of Carol Davila, Bucharest, Romania.
Department of Neurosurgery, Baghdad Medical College, Baghdad, Iraq.
Surg Neurol Int. 2025 May 30;16:209. doi: 10.25259/SNI_183_2025. eCollection 2025.
Pseudoaneurysm formation at the anastomotic site of extracranial-intracranial (EC-IC) bypass surgery is a rare but potentially severe complication. Due to its unpredictable nature and associated risks, early detection and appropriate management are crucial. However, the rarity of this condition makes diagnosis and treatment challenging. This review explores the pathophysiology, risk factors, diagnostic strategies, and management options for pseudoaneurysms in EC-IC bypass procedures.
A comprehensive literature search was conducted using the PubMed/MEDLINE database to identify studies related to pseudoaneurysm formation following EC-IC bypass surgery. The search algorithm applied was (((Pseudoaneurysm) AND (Extracranial) AND (Intracranial)) AND ((Bypass) OR (Revascularization) OR (Anastomosis))). Studies were included if they reported on pseudoaneurysm formation at the anastomotic site of EC-IC bypass procedures, including case reports, case series, retrospective studies, and reviews. Exclusion criteria encompassed studies focusing solely on nonanastomotic aneurysms, unrelated cerebrovascular procedures, or insufficient clinical data.
After applying the inclusion and exclusion criteria, a total of five studies were selected for detailed analysis. The extracted data included patient demographics, clinical presentation, imaging modalities used for diagnosis, treatment strategies, and postoperative outcomes.
Pseudoaneurysms at EC-IC bypass sites pose significant diagnostic and therapeutic challenges. Given the potential for delayed complications, early detection, and individualized treatment strategies are essential. Long-term follow-up with serial imaging is necessary to monitor for recurrence and ensure optimal patient outcomes. Greater awareness and reporting of these cases will contribute to improved understanding and management of this rare complication.
颅外-颅内（EC-IC）旁路手术吻合口处假性动脉瘤形成是一种罕见但可能严重的并发症。由于其性质不可预测且存在相关风险，早期检测和适当处理至关重要。然而，这种情况的罕见性使得诊断和治疗具有挑战性。本综述探讨了EC-IC旁路手术中假性动脉瘤的病理生理学、危险因素、诊断策略和处理选择。
使用PubMed/MEDLINE数据库进行全面的文献检索，以识别与EC-IC旁路手术后假性动脉瘤形成相关的研究。应用的检索算法为（（（假性动脉瘤）AND（颅外）AND（颅内））AND（（旁路）OR（血管重建）OR（吻合术）））。如果研究报告了EC-IC旁路手术吻合口处的假性动脉瘤形成，包括病例报告、病例系列、回顾性研究和综述，则纳入研究。排除标准包括仅关注非吻合口动脉瘤、不相关的脑血管手术或临床数据不足的研究。
应用纳入和排除标准后，共选择了五项研究进行详细分析。提取的数据包括患者人口统计学、临床表现、用于诊断的影像学方法、治疗策略和术后结果。
EC-IC旁路部位的假性动脉瘤带来了重大的诊断和治疗挑战。鉴于可能出现延迟并发症，早期检测和个体化治疗策略至关重要。需要进行系列影像学的长期随访，以监测复发情况并确保患者获得最佳预后。提高对这些病例的认识和报告将有助于更好地理解和处理这种罕见并发症。
