Aneurismas da artéria e da veia braquial induzidos por uso contínuo de muleta: relato de caso

Abstract

Crutch-induced arterial aneurysm is a rare event and there are no descriptions in the literature of cases with concomitant venous aneurysms. We report the case of a patient who, after prolonged crutch use, presented with acute ischemia of the upper limb secondary to brachial artery aneurysm thrombosis, associated with the incidental finding of brachial vein aneurysms. Although the main cause of acute upper limb occlusion is embolization of cardiac origin, consideration should be given to the possibility of arterio-arterial embolization due to an aneurysm induced by prolonged use of crutches. Venous aneurysms should also be suspected since they can be sites of thrombosis, and a source of pulmonary embolism.Keywords: vascular system injuries; aneurysm; brachial artery. ResumoO aneurisma arterial induzido por uso de muleta é um evento raro, e a associação com aneurismas venosos não está descrita na literatura. Relatamos o caso de uma paciente que, após o uso prolongado dessa órtese, apresentou quadro de isquemia aguda de membro superior secundária à trombose de um aneurisma da artéria braquial, associado ao achado incidental de aneurismas da veia braquial. Embora a principal causa de oclusão arterial aguda de membro superior seja a embolização de fonte cardíaca, deve-se considerar a possibilidade de embolização arterioarterial por aneurismas provocados pelo uso prolongado de muletas. Os aneurismas venosos também devem ser suspeitados, uma vez que podem ser sede de trombos e fonte de êmbolos pulmonares.Palavras-chave: lesões do sistema vascular; aneurisma; artéria braquial.

True brachial artery aneurysm: A systematic review

“…118 It has also been observed that TBAA are not only limited to genetic pathologies, but may also arise as a complication to a systemic pathology that may affect the haemodynamics of the arterial system in a secondary manner. [13][14][15][16][17][18][19][20][21][22][23][24]119 Findings noted in the current review also confirmed of the above theory. It was found that 51.5% patients with TBAA had a history of CRF with AVF creation in the affected limb and received 1-2 RTs.…”

“…It was observed that the upper end of a crutch put pressure in axilla which gradually damaged the brachial artery wall by pressing it against the humerus bone, causing aneurysm formation. [19][20][21][22][23][24] These findings shed light on the risk of aneurysm development associated with prolonged use of such walking aids and warrant caution to be taken by physicians and physiotherapists. 19 Remaining aetiologies / risk factors that were found included primary/idiopathic aneurysm, connective tissue 118 Symptoms observed were mostly upper extremity swelling and pain.…”