Surgical Treatment of Aneurysms in the Upper Limbs

Abstract

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.

A Case of True Brachial Artery Aneurysm with Severe Left Upper Limb Ischemia

“…Igari et al previously reported five aneurysms of the upper limbs from 2000 to 2012, and only one of the aneurysms was a true BA aneurysm with an asymptomatic mass. 6 The Cleveland and the Mayo Clinics identified only one case of a true BA aneurysm in 581 brachial artery reconstructions performed between January 1989 and December 2000, 7 and only two cases over a 20-year period, 1 respectively. Although we have often treated false aneurysms or shunt blood vessel dilatation or aneurysms in the upper limbs, the present true BA aneurysm is the first case in our hospital.…”

Posttraumatic pseudoaneurysm of a superficial branch of the ulnar artery: A case report

“…It consists of resection of the lesion allowing decompression if necessary [ 18 ]. This treatment may be associated or not with revascularization depending on the presence of adequate perfusion of the limb and hand [ 19 ]. Suture removal and venous bypass to restore vascular anatomy are the techniques used to carry out revascularization [ 17 ].…”

“…Some authors propose endovascular procedures such as angioplasty with stent or stent grafting, or embolization by interventional radiography [ 5 , 17 ]. These alternative options remain controversial [ 19 ]. In 2004, Komorowska-Timek et al reported the successful use of ultrasound-guided thrombin injection in the treatment of a false radial artery aneurysm at 3 cm and another false ulnar artery aneurysm at 2.5 cm resulting from arterial trauma during a failed catheterization [ 3 , 5 , 21 ].…”

“…The authors favor surgical treatment. This treatment is still the subject of debate, but surgical management seems to us to be the most appropriate [ 19 , 25 ]. Abstention from therapy also seems possible, with close monitoring if the aneurysm is asymptomatic or small [ 3 ].…”

Pseudoaneurysma der Arteria ulnaris

“…Pseudoaneurysmen der A. ulnaris sind extrem seltene Ereignisse, über die es nur vereinzelt Fallberichte gibt [1]. Die Entstehung eines Pseudoaneurysmas der A. ulnaris wird mit penetrierenden Traumen, Kanülierungen der A. ulnaris, mit dem Hypothenar-Hammer-Syndrom oder perioperativen Traumen assoziiert [2].…”