Brachial, radial, and ulnar arteries in the endovascular era: choice of intervention.
ABSTRACT To say that endovascular techniques have revolutionized treatment of aortic aneurysms is an understatement. These same techniques and principles are now being applied to peripheral aneurysms. Because of the small diameter of the arteries in the arm, the relative scarcity of true aneurysms of these arteries, and the fact that these arteries are readily accessible, open surgery remains the mainstay of therapy. On the other hand, nonsurgical approaches are playing an important role in the treatment of peripheral pseudoaneurysms and aneurysmal changes associated with arterial and venous access. This article reviews the natural history, treatment, and outcomes of aneurysms of the radial, brachial, and ulnar arteries. We will also focus on interventional treatment of pseudoaneurysms.
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ABSTRACT: Naturally formed arteriovenous fistula (AVF) causing local vascular aneurysm dilatation in the forearm ulnar artery region is rare and is exceedingly uncommon in any age group. Presented is a case of AVF in the left ulnar artery of a 39-year-old man in whom there was no history of trauma; the deformity had been noted since childhood. The AVF had become tortuous and enlarged in size as the patient aged. As a result, aneurysm dilatation formed on the base of the AVF and that of the ulnar artery origin. Despite normal preoperative Allen test result and normal preoperative finger pressure measurement with ulnar artery occlusion, arterial duplex imaging showed that the radial artery was the dominant artery of the left arm; the AVF was resected and the base of the aneurismal dilatation, which was directly related to the ulnar artery, was repaired for the sake of the natural continuity of ulnar blood flow.Journal of the Chinese Medical Association 01/2009; 71(12):651-4. DOI:10.1016/S1726-4901(09)70010-3 · 0.89 Impact Factor
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ABSTRACT: Infected aneurysm (IA) of the anterior interosseal artery (AIA), the first branch of the ulnar artery, is an infrequent but serious complication of infectious endocarditis (IE). We report a successful case of excision of IA arising from AIA. In this case, the IA expanded and adhered to the ulnar artery, resulting in occlusion of the ulnar artery. Reconstruction of the ulnar artery was not needed by the preoperative evaluation and the intraoperative occlusion testing. We discuss surgical treatment of IA following IE in upper extremities.Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 04/2011; 53(4):1104-6. DOI:10.1016/j.jvs.2010.10.113 · 2.98 Impact Factor
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ABSTRACT: BACKGROUND: Palsies involving the anterior interosseous nerve (AIN) comprise less than 1% of all upper extremity nerve palsies. OBJECTIVES: This case highlights the potential vascular and neurological hazards of minimal penetrating injury of the proximal forearm and emphasizes the phenomenon of delayed presentation of vascular injuries following seemingly obscure penetrating wounds. CASE REPORT: We report a case of a 22-year-old male admitted for a minimal penetrating trauma of the proximal forearm that, some days later, developed an anterior interosseous syndrome. A Duplex study performed immediately after the trauma was normal. Further radiologic investigations i.e. a computer-tomographic-angiography (CTA) revealed a false aneurysm of the proximal portion of the interosseous artery (IA). Endovascular management was proposed but a spontaneous rupture dictated surgical revision with simple excision. Complete neurological recovery was documented at 4 months postoperatively. CONCLUSIONS/SUMMARY: After every penetrating injury of the proximal forearm we propose routinely a detailed neurological and vascular status and a CTA if Duplex evaluation is negative.Journal of Orthopaedic Surgery and Research 12/2009; 4:44. DOI:10.1186/1749-799X-4-44 · 1.58 Impact Factor