A Large True Brachial Artery Aneurysm in an Infant

Abstract

A 6-month-old male was admitted to the children’s hospital for management of an underlying gastrointestinal illness. During his admission, a large, pulsatile mass was incidentally noted in the left upper arm concerning for an expanding pseudoaneurysm. Vascular surgery was consulted, and further workup with a CT angiogram demonstrated a brachial artery aneurysm 3 cm in greatest diameter. The patient was taken to the operating room, where lateral aneurysmorraphy was performed without complication. His neurovascular exam remained intact postoperatively. The presented case demonstrates a viable approach to the surgical management of this clinical challenge in infants. Although reports of brachial artery aneurysm in this age group are rare in the literature, resection with primary repair and interposition grafting have also been described. Long-term outcomes are not available in these cases. Lateral aneurysmorraphy allows for ongoing monitoring and future resection and bypass of the aneurysm as the patient continues to grow.