Giant aneurysm of the ulnar artery in the palm treated by resection and microvascular reconstruction

Abstract

We report a giant aneurysm in the palm that was arising from the ulnar artery. We treated it successfully by resection followed by microvascular reconstruction with a vein graft.

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

“…Even when they do occur, it is usually secondary to repetitive trauma or direct injury resulting in pseudoaneurysms. Distal radial and ulnar artery aneurysms have been reported due to repetitive trauma to the hand among manual labourers [3,4]. More recently with increasing incidence of endovascular interventions through radial artery approach, iatrogenic pseudoaneurysms of the distal radial artery have also been reported.…”

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

“…Therefore, to the best of our knowledge, the above reported case represents the first documented case of bilateral true DUAA to date. True FAHAAs are very rare; over the last 20 years the majority of these have been described only sporadically as case reports both in adults [5][6][7]11,15,16,[27][28][29][30][31][32] and in children. [8][9][10]12,14,17,33 Furthermore, most of the papers on this subject consider 'true' aneurysm cases, which are in fact of a different nature.…”

“…Whereas when artery continuity reconstruction is considered necessary, this can be achieved by primary end-to-end anastomosis of the severed artery 3,11 or by an interposition of vein graft. 4,10,12 Reversed saphenous vein artery interposition 10 and ipsilateral superficial dorsal hand 12 or forearm vein interposition graft 16 have been successfully experimented in this field. Recently, small caliber arteries segments (e.g.…”

“…However, when the arterial diameter is equal or less than 2.5 mm the use of microsurgical technique and high-power magnification should be considered mandatory. 11,12,16,36 The contralateral DUAA was treated conservatively because of the lack of symptoms and minor possibilities of rupture and ischemic complications. At 36 months follow-up no significant increase in diameter was observed (0.8 cm instead of 0.6 cm at origin).…”

“…Regarding ulnar artery in the palm and wrist in particular, only 15 true distal ulnar artery aneurysms (DUAA) have been described in the last 20 years (1990-2010). [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Also, as far as we know only one case of bilateral DUAA has been reported 18 since 1933.…”