Brachial, Radial, and Ulnar Arteries in the Endovascular Era: Choice of Intervention
Section of Vascular Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, 68198-3280, USA. Seminars in Vascular Surgery
(Impact Factor: 1.38).
01/2006; 18(4):191-5. DOI: 10.1053/j.semvascsurg.2005.09.004
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.
Available from: Cesare Fusetti
- "Nowadays, nonsurgical approaches play an important role in the treatment of peripheral false aneurysms [16,22]. Endoluminal repair of false aneurysms, large arteriovenous fistulas, intimal flaps, and focal lacerations, is performed by using stent-graft technology. "
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Palsies involving the anterior interosseous nerve (AIN) comprise less than 1% of all upper extremity nerve palsies.
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.
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.
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.
Available from: Nathan E Manghat
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ABSTRACT: We present a case of ulnar artery aneurysm and dissection associated with a congenitally hypoplastic ipsilateral radial artery. We postulate that the aetiology is due to increased blood flow through the ulnar artery as a consequence of the radial artery anomaly, therefore making the ulnar artery more vulnerable to aneurysm formation and traumatic damage. This might represent a variant of the hypothenar hammer syndrome with associated ulnar artery dissection and recurrent distal embolisation manifesting as Raynaud's phenomenon. Forearm arterial injuries, treatment and the importance of upper limb arterial anatomical variations are also discussed. To our knowledge, this is the first reported case of its type diagnosed by multi-detector row computed tomography angiography.
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