Post-traumatic pseudoaneurysm of the brachial artery and its surgical treatment

The frequency of peripheral artery aneurysms in the upper extremities is much less than in the lower extremities. Diagnosis and surgical treatment are important because upper extremity aneurysms can cause severe decreases in function and lead to the loss of an arm or of fingers. We performed aneurysmal resection together with saphenous vein graft interpositioning in 9 patients with a diagnosis of post-traumatic brachial pseudoaneurysm from January 1995 through February 2003. Of these patients, 7 were men (77%). The mean age was 38.2 years (range, 26-46 years. Four patients had gunshot wounds (44%) and 5 had stab wounds (56%). The mean duration from injury to hospital admission was 26.7 months (range, 17 months-7 years). All patients underwent color-flow arterial Doppler ultrasonography and selective upper extremity digital subtraction angiography. In all patients, we performed aneurysmal resection and saphenous vein graft interpositioning. There was no instance of death or ischemic extremity loss. Patients were discharged from the hospital a mean of 3.2 days after surgery (range, 2-6 days). Early and late graft patency rates were 100%. We followed the patients' cases for a mean of 3.4 years (range, 1 month-7 years). Very rarely, post-traumatic upper extremity pseudoaneurysms show symptoms after a long period of time. Diagnosis is very easy with a review of the patient's history and a physical examination; surgical reconstruction is the preferred treatment for such patients.