Superficial Palmar Arch Aneurysm after Carpal Tunnel Decompression, a Rare Complication: A Case Report

Abstract

False aneurysms of the palmar arteries are rare. They are usually associated with traumatic injuries to the hand vasculature. We present a case of superficial palmar arch aneurysm (SPAA), complicating carpal tunnel decompression which presented as a pulsatile mass at the site of previous surgery. Initial diagnosis was made on clinical examination and confirmed on doppler ultrasound (US) and computed tomographic angiography (CTA). The feeding vessel of the aneurysm was subsequently occluded using coil embolization.

Traumatic Pseudoaneurysm of the Superficial Palmar Arch: A Case Report and Review of the Literature

“…Recently, endovascular techniques such as coil embolization have been employed with success in the treatment of the false aneurysms of the superficial palmar arch. This minimally invasive method may be an alternative to open surgery in the management of these lesions [5].…”

“…Ultrasonography is the initial diagnosis in the majority of cases. Angiography can be useful as it can specify the exact location of the aneurysm, the presence of collaterals and may be useful in planning reconstructive surgery, but its use remains controversial due to its potential complications, such as the possibility of distal embolization [5]. In addition, according to Garcia et al, angiography can differentiate the true from the false aneurysms according to their angiographic characteristics: saccular appearance for the false aneurysms and fusiform shape for the true ones [3].…”

“…Pseudoaneurysms of the superficial palmar arch are rare entities and only a few cases have been described in the English literature [1][2][3][4][5][6][7]. The majority of them develop after lesion of the artery due to penetrating trauma, previous surgery and arterial puncture.…”

Pseudoaneurysm: an unusual cause of post-traumatic hand swelling

“…The technique involves resection of the aneurysm followed by end-to-end anastomosis in order to restore blood flow. Radiological techniques such as endovascular embolisation can also be employed as used successfully to treat a superficial palmar arch aneurysm following carpel tunnel decompression 6. Surgical intervention is often favoured in order to avoid significant complications, as aforementioned, but also, particularly in children, to prevent growth retardation 7.…”

Palmar Artery Aneurysm

“…Th ese aneurysms may occur in the superfi cial palmar arch ( 1 ), deep palmar arch ( 9 ), common digital artery ( 10 ), or proper digital artery ( 11 ). A PAA ( 12 ) has arisen from a primary vascular tumor and another after carpal tunnel surgery ( 6 ).…”