Management of true aneurysms distal to the axillary artery

Gray, Richard; Stone, William M.; Fowl, Richard J.; Cherry, Kenneth J.; Bower, Thomas C.

doi:10.1016/s0741-5214(98)70083-7

Cited by 92 publications

(94 citation statements)

References 33 publications

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“…In a study investigating the diagnosis and treatment strategies along with their results in upper extremity aneurysms distal to the axillary artery, it was stated that 67% of the patients consulted due to a pulsatile mass. [8] The second most common symptoms were pain and/or paresthesia. [8] If the lesion is deeper or is shaded by the surrounding hematoma, these symptoms may not occur.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of aneurysms of hemodialysis access arteriovenous fistulas

Karatepe¹,

Yetim²

2011

Turkish J Thorac Cardiovasc Surg

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Section: Discussionmentioning

confidence: 99%

“…[8] The second most common symptoms were pain and/or paresthesia. [8] If the lesion is deeper or is shaded by the surrounding hematoma, these symptoms may not occur. [5] In our study, the main complaint in 28 patients was a palpable mass and findings of a thrill upon physical examination.…”

Section: Discussionmentioning

confidence: 99%

Treatment of aneurysms of hemodialysis access arteriovenous fistulas

Karatepe¹,

Yetim²

2011

Turkish J Thorac Cardiovasc Surg

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“…The size of aneurysms does not seem to relate to symptoms. 1) In the lower extremity aneurysms, there was no significant difference in size comparing asymptomatic with symptomatic aneurysms or those which had thrombosed or not thrombosed. 18) For these reasons, the treatment indications of brachial, radial and ulnar artery aneurysms should not be determined based on the size and the presence of symptoms.…”

Section: Illustrative Casesmentioning

confidence: 83%

Surgical Treatment of Aneurysms in the Upper Limbs

Igari

Kudo

Toyofuku

et al. 2013

Annals of Vascular Diseases

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Objective: The purpose of this study was to review the experience of aneurysms in the upper limbs treated with surgery and assess the outcomes. Materials and Methods: This study retrospectively reviewed the medical records of five patients with upper extremity aneurysms treated with surgical resection at Tokyo Medical and Dental University Hospital between March 2000 and February 2012. These patients were treated with excision surgery either with or without reconstructive surgery. Results: Two of the five patients were males and three were females with a mean age of 52 years (age range: 25-72 years). We treated 2 brachial, 2 ulnar, and 1 radial aneurysms. All aneurysms were excised, and two patients had reconstructive surgery. Three patients had false aneurysms, which included an ulnar artery aneurysm diagnosed as angiolymphoid hyperplasia with eosinophilia. During follow-up period, all grafts were clinically patent, and no cases had recurrent lesions. No patients had ischemic symptoms or any other postoperative complications. Conclusion: Arterial aneurysms of the upper extremities are uncommon, and were most commonly caused by non-traumatic etiology in this series. These aneurysms were excised with or without reconstructive surgery, because of the fear of rupture and embolization. Revascularization can be performed selectively.

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“…1 The Mayo clinics at Rochester and Arizona identified only two brachial artery aneurysms after reviewing all cases of true upper limb aneurysms, distal to the axillary artery, over a twenty-year period. 2 The presence of a concurrent aneurysm was noted in only 8% of cases. These aneurysms most commonly presented as an asymptomatic mass while the presence of pain and paraesthesia were less frequent.…”

Section: Discussionmentioning

confidence: 97%

“…2 Functionally, these aneurysms resemble popliteal aneurysms, with the lower risk of rupture and symptoms attributable to compression, and distal embolisation. 2 Leon et al reviewed mycotic aneurysms of the upper limb and identified the brachial artery to be the most common site, usually arising secondary to intravenous drug abuse, prosthetic valve endocarditis and invasive catheterisation procedures. 3 Congenital causes of upper limb aneurysms include vasculitic conditions such as giant cell arteritis and polyarteritis nodosa as well as connective tissue disorders such as Ehlers-Danlos syndrome.…”

Section: Discussionmentioning

confidence: 99%

Swelling in the upper arm: the presentation and management of an isolated brachial artery aneurysm

Alagaratnam

Choong

Lau

et al. 2011

annals

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True aneurysms of the brachial artery are uncommon. We describe the presentation and surgical management of an isolated, brachial artery aneurysm in a 64-year-old woman. Excision of the aneurysm and long saphenous venous interposition grafting was performed with no postoperative complications and histology demonstrated true aneurysmal degeneration. case history A 64-year-old woman presented with a 2-month history of progressive swelling in the medial aspect of her left upper arm. This was associated with paraesthesia in the lateral three fingers of her left hand. She did not report a history of pain, pyrexia, preceding trauma, intravenous drug use or previous catheterisation of her vasculature. Her previous medical history included well controlled hypertension, with an angiotensin-converting enzyme inhibitor and a thiazide diuretic, and mild asthma. There was no family history of connective tissue disorders or aneurysmal disease. Ann R Coll Surg EnglA physical examination demonstrated a 3cm x 5cm pulsatile mass that was mobile in the transverse plane and fixed in the longitudinal plane. The brachial and radial pulses were normal on palpation and no evidence of distal vascular insufficiency was noted. A neurological examination demonstrated altered sensation in the distribution of the median nerve. Ultrasonography revealed a large pulsatile aneurysm and the diagnosis of a secular proximal brachial artery aneurysm was confirmed by a computed tomography angiogram (Fig 1). Transthoracic echocardiography and duplex ultrasonography of the remaining vasculature did not identify any other abnormalities. The patient's blood tests were unremarkable with normal inflammatory markers.The surgical management of the aneurysm was performed under general anaesthetic. Dissection of the aneurysm revealed the sac to be adherent and compressing the median nerve (Fig 2). Complete dissection and mobilisation of the sac confirmed its saccular morphology. An approximately 3cm segment of the affected artery was excised and a reversed short segment of the long saphenous vein from the patient's left thigh was used as an interposition graft, anastomosed proximally and distally with 7/0 polypropylene. A gentamicin-collagen sponge (Collatamp ® , EUSA Pharma, Oxford, UK) was left in situ prior to closure. The patient was discharged two days later after an uneventful recovery with complete resolution of paraesthesia in the median nerve distribution. No complications were noted after four months of follow-up.The aneurysm histology demonstrated age-related degenerative changes with intimal thickening and thinning of the media consistent with aneurysmal degeneration (Fig 3). discussionThe aetiology of brachial artery aneurysms includes infections (mycotic), trauma, congenital conditions and atherosclerosis. True aneurysms affecting the brachial artery are very rare. The Cleveland Clinic identified only 1 of 581 procedures on brachial arteries over an 11-year period as involving true aneurysms.1 The Mayo clinics at Rochester and Arizona ide...

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Management of true aneurysms distal to the axillary artery

Cited by 92 publications

References 33 publications

Treatment of aneurysms of hemodialysis access arteriovenous fistulas

Treatment of aneurysms of hemodialysis access arteriovenous fistulas

Surgical Treatment of Aneurysms in the Upper Limbs

Swelling in the upper arm: the presentation and management of an isolated brachial artery aneurysm

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