Introduction True non-traumatic radial artery aneurysms (RAAs) are extremely rare, and few cases have been described. The majority of RAAs are post-traumatic or iatrogenic pseudo-aneurysms following arterial cannulation. However, RAAs due to other causes have also been described. Here a rare case of true idiopathic distal RAA, which was managed by surgical resection and repair with interposition vein graft, is described. Report A 62 year old female with a known medical history of hypertension and hyperlipidaemia presented with left wrist swelling of one year duration, associated with a pulsatile lump that was increasing in size. Duplex ultrasound and computed tomography angiography revealed a distal RAA. She underwent open surgical resection and repair with interposition vein graft using the distal left cephalic vein. Histopathology of the specimen revealed an aneurysm with atherosclerosis. She recovered well post-operatively with no complications. Discussion True idiopathic RAAs are rare. Surgical treatment is almost always recommended in view of the risk of complications. A case of true idiopathic distal RAA is presented here, which was managed successfully by surgical resection and repair with interposition vein graft.

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Background Isolated mycotic internal iliac artery aneurysms are rare and management of these patients can be complex. Case summary We present a rare case of isolated mycotic right internal iliac artery aneurysm caused by Salmonella enteritides. This was managed in stages – with intravenous antibiotics, followed by endovascular stenting and embolization, and subsequent percutaneous drainage of the remnant collection. The patient had no perioperative complications, and has remained well at more than 18 months post-operatively with no evidence of stent infection. Conclusion A minimally-invasive approach combining endovascular aneurysm repair and percutaneous drainage is a viable option in the management of a mycotic internal iliac artery aneurysm.