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Brachial Artery Aneurysm

Section Editor James S.T. Yao

Brachial Artery Aneurysm

Mark K. Eskandari, M.D.
Northwestern University, Chicago, IL

Brief Case History

A 40-year-old man presented with an asymptomatic left antecubital fossa pulsatile mass. Prior history includes renal failure ultimately treated with a transplant and an old occluded left forearm Brescia-Cimino fistula. Duplex (Figure 1) demonstrates a thrombus-filled primary left brachial artery aneurysm. A preoperative MRA confirms the findings and documents occlusion of the left radial artery but a patent left ulnar artery (Figure 2). Intraoperative findings are shown in Figures 3 and 4. The aneurysm was excised and the patient underwent a successful left brachial to ulnar artery bypass with reversed greater saphenous vein (Figure 5).

Figure 1: Duplex scan (transverse view) showing aneurysm of the brachial artery with thrombus.
Figure 2: MRA of brachial artery, right and left. The right brachial artery is ectatic and larger than the left. The brachial artery is dilated above the bifurcation.
Figure 3: Operative photography of aneurysm of the brachial artery.
Figure 4: Multiple thrombi were seen in the lumen of the aneurysm.
Figure 5: Interposed saphenous vein graft to replace the brachial aneurysm.
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