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Case Reports
. 2020 Nov 21:49:34-39.
doi: 10.1016/j.ejvsvf.2020.11.003. eCollection 2020.

True Idiopathic Radial Artery Aneurysm: A Case Report and Review of Current Literature

Y M Madeline Chee  1 , Pei Shi Lew  1 , M J Darryl Lim  1
Affiliations
Case Reports

True Idiopathic Radial Artery Aneurysm: A Case Report and Review of Current Literature

Y M Madeline Chee et al. EJVES Vasc Forum. .

Abstract

Introduction: True non-traumatic radial artery aneurysms (RAAs) are extremely rare, and few cases have been described. The majority of RAAs are post-traumatic or iatrogenic pseudo-aneurysms following arterial cannulation. However, RAAs due to other causes have also been described. Here a rare case of true idiopathic distal RAA, which was managed by surgical resection and repair with interposition vein graft, is described.

Report: A 62 year old female with a known medical history of hypertension and hyperlipidaemia presented with left wrist swelling of one year duration, associated with a pulsatile lump that was increasing in size. Duplex ultrasound and computed tomography angiography revealed a distal RAA. She underwent open surgical resection and repair with interposition vein graft using the distal left cephalic vein. Histopathology of the specimen revealed an aneurysm with atherosclerosis. She recovered well post-operatively with no complications.

Discussion: True idiopathic RAAs are rare. Surgical treatment is almost always recommended in view of the risk of complications. A case of true idiopathic distal RAA is presented here, which was managed successfully by surgical resection and repair with interposition vein graft.

Keywords: Idiopathic; Interposition graft; Radial artery; True aneurysm.

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Figures

Figure 1
Figure 1
Pre-operative photographs of the patient's left hand showing a lump in the anatomical snuffbox (red arrows).
Figure 2
Figure 2
(A) Duplex ultrasound and (B) computed tomography angiogram showing the distal radial artery aneurysm in the area of the anatomical snuffbox.
Figure 3
Figure 3
Intra-operative photographs showing (A,B) the radial artery aneurysm identified with proximal and distal control achieved, (C) completed repair with cephalic vein interposition graft with end to end anastomosis, and (D) the resected radial artery aneurysm.
Figure 4
Figure 4
Histopathology images of the excised radial artery aneurysm with H&E (left) and EVG (right) stains. Sections of the vessel show fibrotic and focally thinned out wall with loss of internal elastic lamina. There is also intimal thickening and atherosclerotic changes.
See this image and copyright information in PMC

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