Forearm and hand arteries' aneurysms – a case report of bilateral true ulnar artery aneurysm in the hypothenar eminence and systematic review of the literature

Abstract

Arterial aneurysms in the forearm, wrist and hand are relatively uncommon. Penetrating injuries, arterial traumas, infections and repetitive microtraumas represent the most frequent cause of these secondary aneurysms or pseudo-aneurysms, while true nontraumaticor infective peripheral aneurysms of the upper extremities are very rarely encountered. Over the last 20 years these have been reported only sporadically, both in adults and children. We describe a case of bilateral true idiopathic saccular artery aneurysms in the hypothenar eminence, treated with excision and arterial continuity restoration by primary end-to-end anastomosis on the left side and conservatively on the right. To our knowledge, no other similar case has been documented to date. Starting from this original case we conducted a systematic review of the literature via PubMed search on peripheral aneurysms of the forearm and hand arteries from 1933 to the present, including specifically true distal ulnar and radial artery aneurysms. Etiology, clinical characteristics and management of these rare pathological entities are extensively discussed.

Ulnar artery aneurysm - A rare cause of mass on wrist

“…In surgical treatment, thoracic sympatectomy, ulnar artery aneurysm excision, ulnar artery ligation, anastomosis of ulnar artery by microsurgery or vein interposition can be performed [3,4]. Ulnar artery aneurysm and surgical treatment is reported in the literature very rarely [5]. In these type cases, Ehlers-Danlos syndrome should be considered [6].…”

Non-traumatic ulnar artery aneurysm in a middle-aged male

“…While spontaneous aneurysms in the brachial artery have been reported sporadically, aneurysms arising in the forearm arteries distal to the brachial artery bifurcation are extremely uncommon [1]. Santis and colleagues (2013) in a systematic review covering 20 years , reported just 28 cases of non-traumatic forearm aneurysms, the majority of which were distal palmar aneurysms [2]. We report a rare case of a non-traumatic ulnar artery aneurysm in a 39-year-old active male who presented with acute pain and tenderness in the forearm.…”