Abstract
A non-anastomotic pseudoaneurysm is rare, and we present an unusual case of non-anastomotic pseudoaneurysm that occurred almost two decades postoperatively. A 62-year-old man had undergone abdominal aortic replacement with a bifurcated prosthesis graft 20 years previously. A Y-shaped Dacron graft had been used, and proximal anastomosis was performed at the infrarenal neck of the aneurysm. The graft was then anastomosed end-to-side to the right common femoral artery, and end-to-end anastomosis was performed to the left common iliac artery. The right common iliac artery was ligated, and his initial postoperative course was uneventful. However, 18 years later, computed tomography revealed a pseudoaneurysm developing at the non-anastomotic site due to prosthetic graft failure. The failed portion of the graft was resected and was replaced with a 16-mm J graft. The second operative course was uneventful. This case demonstrates the importance of carefully monitoring patients for the potential formation of pseudoaneurysms, especially if an arterial graft has been used below the groin, and even if it has been many years since the initial surgery was performed.
