True Idiopathic Brachial Artery Aneurysm: A Rare Case of Surgical Emergency

Raja, Nayem; Kisku, Navnita; Gupta, Latika; Geelani, Muhammad Abid

doi:10.4103/0972-0820.198072

Cited by 1 publication

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“…Bypass with greater saphenous vein interposition graft has been the most frequently employed treatment. 2,3,[23][24][25][26][27] We decided to use the right great saphenous vein in this patient, because it was the largest conduit available. The cephalic vein 14 or the basilic vein 28 have also been used with the theoretical advantage of avoiding an incision in lower extremity and preserving the saphenous vein for possible future vascular reconstructions.…”

Section: Discussionmentioning

confidence: 99%

True Idiopathic Brachial Artery Aneurysm Treated With a Saphenous Vein Graft

González-Urquijo

Marine

Vargas

et al. 2022

Vasc Endovascular Surg

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Purpose: The objective of this study is to report a case of a 65-year-old woman who presented with pallor and pain of her left arm secondary to a true arterial brachial aneurysm, which was successfully treated with saphenous vein bypass and embolization of the aneurysm sac. A review of the literature is also presented. Case report: A 65-year-old woman presented with an acute onset of pallor and pain of her left forearm, and hand. On physical examination, there was a pulsatile mass at the forearm. A doppler ultrasound showed a fusiform aneurysmal dilatation of the brachial artery of 23 mm of diameter. A dynamic contrast-enhanced MRI angiogram confirmed a fusiform dilation of the distal brachial artery. The patient was scheduled for open repair. A fusiform 20 x 60 mm aneurysm of the distal brachial artery extending to the cubital fossa was found and a brachial artery to radial and ulnar arteries bypass with interposed reverse right saphenous vein was created. Embolization of the aneurysm sac was performed using Gelita-spon ® (Gelita Medical, Eberbach, Germany). A final angiogram showed an adequate perfusion through the bypass to the hand, and no contrast in the aneurysmal sac. Postoperative course was uneventful with discharge on the fourth postoperative day. Conclusion: Revascularization with autologous saphenous vein graft and exclusion of the aneurysm with local embolization is a good treatment alternative in a patient with symptomatic brachial aneurysm with distal embolization.

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