Posttraumatic True Aneurysm of the Axillary Artery Following Blunt Trauma

Abstract

The majority of the axillary artery aneurysm cases arise as pseudoaneurysms secondary to blunt or iatrogenic trauma. Isolated traumatic true axillary artery aneurysm is a relatively unusual disorder and generally occurs with repetitive blunt trauma. A 22-year-old female patient with distal axillary artery true aneurysm due to simple blunt axillothoracic trauma is presented. The aneurysm was excised with subpectoral-axillary approach and saphenous vein graft interposition was applied. Long-term follow-up with the patient was uneventful.

Axillary artery aneurysm

“…Diagnosis and treatment of axillary artery aneurysms is important due to the potential to threaten the affected upper extremity causing vascular complications such as thrombo‐embolic events. The brachial artery may occlude, as it did with this case . An aneurysm in the axillary artery may also cause neurological complications if there is extrinsic compression of the brachial plexus by the aneurysm .…”

“…True aneurysms of the axillary artery most commonly arise due to atherosclerosis or due to blunt, repetitive trauma to the area . The formation process for true aneurysm may be due to the compression of the wall of the affected artery, which results in contusion of the media, weakening of the wall of the artery, and dilatation is the subsequent outcome .…”

“…Blunt trauma to the axillary artery; an example of which is the repeated use of crutches, results in the arterial wall being weakened over time . Athletes that use a repetitive, forceful motion of the upper limb, such as baseball pitchers are also noted to develop true aneurysms of the axillary artery .…”

“…True aneurysms may present as a mass, with or without pulsatility . Patient symptoms may include pain, numbness or coldness to the affected upper extremity . The patient may report feeling fatigued in the affected upper limb or experience cramping with the use of the affected upper limb.…”

“…Pseudo‐aneurysms occur due to trauma to the area, and therefore, focal puncture of the axillary artery wall occurs. As a result, the aneurysm forms in the surrounding tissue . A true aneurysm is when the size of the artery is twice its normal diameter …”