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A Rare Case of a Spontaneous Brachial Artery Aneurysm

A Rare Case of a Spontaneous Brachial Artery Aneurysm The Journal for Vascular Ultrasound 40(2):90, 2016 A Rare Case of a Spontaneous Brachial Artery Aneurysm Kathy Pazienza, LPN, RVT ABSTRACT Brachial artery aneurysms and pseudoaneurysms are rare. What follows is a case of a pseudoaneurysm found in the right brachial artery in the mid upper arm. The patient denied trauma and there had not been any needle injections previously. The initial diagnosis was either a pseudoaneurysm or a saccular aneurysm. Surgical exploration suggested a spontaneous pseudoaneurysm. A 77 year old female presented to the vascular lab which does not contain arterial wall layers but rather a with a complaint of a “lump” in her right upper arm. pulsating hematoma completely separate from the ar- The location of the area of complaint was the mid right tery except for the communicating channel through brachial artery. The onset of symptoms was a few which the blood travels to reach it. A saccular aneu- months prior. There had not been any change in its size rysm is a localized out-pouching of an artery, resulting and she was otherwise asymptomatic. There was no from wall thinning and stretching. The etiology of an history of trauma, intervention, illness or bacteremia. aneurysm is atherosclerosis, trauma, dissection, infec- Duplex revealed what appeared to be either a saccular tion, congenital abnormalities, and connective tissue aneurysm or a pseudoaneurysm. Surgical operative disorders. Risk factors are: smoking, hypertension, dys- note stated a pseudoaneurysm. It appeared to be a lipidemia, chronic obstructive pulmonary disease. “spontaneous pseudoaneurysm”. These are rare, and Lower extremity aneurysms are more common than there are a few cases reported in the literature of a brachial artery aneurysms spontaneous femoral pseudoaneurysm. These are usu- Surgery was recommended due to the potential of ally caused by atherosclerotic disease or a congenital distal limb ischemia. The patient had surgery and the connective tissue disorder. No atherosclerosis was noted diagnosis of a pseudoaneurysm was made. She did very in the brachial artery proximal or distal to the pseudo- well with surgery and will continue to be followed up aneurysm on ultrasound. No apparent connective tis- with non-invasive exams. sue disorder has been noted in this patient. The Duplex revealed an aneurysm measuring 1.8 cm. Duplex ultra- References sound is a valuable tool in diagnosing true and false 1. Fakhree MB, Azhough R, Quran FQ. A case of true brachial aneurysms. In this case, although a Duplex was done artery aneurysm in an elderly male. J Cardiovasc Thoras Res 2012;4: 25–27. in order to determine if there was an aneurysm, it was 2. Size GP, Lozanski L, Russo T. Inside vascular Ultrasound hard to differentiate whether this was a pseudoaneu- Reference Guide. Pasadena, CA: Davies Publishing Inc.; 2013. rysm or a saccular aneurysm. 3. MA Ghazi, Khan MK, Akram Y, et al. Brachial artery aneurysm. A true aneurysm is a dilation of all layers of the arte- JAMAJ 2006;49:173–175. Available at: www.med.or.jp/english/pdf/ rial wall, differentiating it from a pseudoaneurysm, 2006_04/173_175.pdf. Address correspondence to: Kathy Pazienza, LPN, RVT, 3930 Cedar Run Road, Traverse City, MI 49684. E-mail: kathy@vascu- larcentermi.com http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal for Vascular Ultrasound SAGE

A Rare Case of a Spontaneous Brachial Artery Aneurysm

Pazienza, Kathy
Journal for Vascular Ultrasound , Volume 40 (2): 1 – Jun 1, 2016
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Publisher
SAGE
Copyright
© 2016 Society for Vascular Ultrasound
ISSN
1544-3167
eISSN
1544-3175
DOI
10.1177/154431671604000206
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Abstract

The Journal for Vascular Ultrasound 40(2):90, 2016 A Rare Case of a Spontaneous Brachial Artery Aneurysm Kathy Pazienza, LPN, RVT ABSTRACT Brachial artery aneurysms and pseudoaneurysms are rare. What follows is a case of a pseudoaneurysm found in the right brachial artery in the mid upper arm. The patient denied trauma and there had not been any needle injections previously. The initial diagnosis was either a pseudoaneurysm or a saccular aneurysm. Surgical exploration suggested a spontaneous pseudoaneurysm. A 77 year old female presented to the vascular lab which does not contain arterial wall layers but rather a with a complaint of a “lump” in her right upper arm. pulsating hematoma completely separate from the ar- The location of the area of complaint was the mid right tery except for the communicating channel through brachial artery. The onset of symptoms was a few which the blood travels to reach it. A saccular aneu- months prior. There had not been any change in its size rysm is a localized out-pouching of an artery, resulting and she was otherwise asymptomatic. There was no from wall thinning and stretching. The etiology of an history of trauma, intervention, illness or bacteremia. aneurysm is atherosclerosis, trauma, dissection, infec- Duplex revealed what appeared to be either a saccular tion, congenital abnormalities, and connective tissue aneurysm or a pseudoaneurysm. Surgical operative disorders. Risk factors are: smoking, hypertension, dys- note stated a pseudoaneurysm. It appeared to be a lipidemia, chronic obstructive pulmonary disease. “spontaneous pseudoaneurysm”. These are rare, and Lower extremity aneurysms are more common than there are a few cases reported in the literature of a brachial artery aneurysms spontaneous femoral pseudoaneurysm. These are usu- Surgery was recommended due to the potential of ally caused by atherosclerotic disease or a congenital distal limb ischemia. The patient had surgery and the connective tissue disorder. No atherosclerosis was noted diagnosis of a pseudoaneurysm was made. She did very in the brachial artery proximal or distal to the pseudo- well with surgery and will continue to be followed up aneurysm on ultrasound. No apparent connective tis- with non-invasive exams. sue disorder has been noted in this patient. The Duplex revealed an aneurysm measuring 1.8 cm. Duplex ultra- References sound is a valuable tool in diagnosing true and false 1. Fakhree MB, Azhough R, Quran FQ. A case of true brachial aneurysms. In this case, although a Duplex was done artery aneurysm in an elderly male. J Cardiovasc Thoras Res 2012;4: 25–27. in order to determine if there was an aneurysm, it was 2. Size GP, Lozanski L, Russo T. Inside vascular Ultrasound hard to differentiate whether this was a pseudoaneu- Reference Guide. Pasadena, CA: Davies Publishing Inc.; 2013. rysm or a saccular aneurysm. 3. MA Ghazi, Khan MK, Akram Y, et al. Brachial artery aneurysm. A true aneurysm is a dilation of all layers of the arte- JAMAJ 2006;49:173–175. Available at: www.med.or.jp/english/pdf/ rial wall, differentiating it from a pseudoaneurysm, 2006_04/173_175.pdf. Address correspondence to: Kathy Pazienza, LPN, RVT, 3930 Cedar Run Road, Traverse City, MI 49684. E-mail: kathy@vascu- larcentermi.com

Journal

Journal for Vascular Ultrasound – SAGE

Published: Jun 1, 2016

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