A Challenging Surgical Case of Axillary Artery Pseudoaneurysm Weeks after Blunt Trauma

Anthony Feghali,Dawn Salvatore,Brandon Nussenblatt,Babak Abai,Paul Dimuzio

doi:10.31487/j.jscr.2020.02.10

Abstract

Axillary artery injury is a rare complication of blunt upper extremity trauma and is reported in the literature on only a few cases. The usual treatment is an open operation with the exclusion of the aneurysm and interposition grafting. Vascular injury in the elderly population after trauma is especially “dangerous” owing to a large cohort of these patients being on anticoagulation. For this reason, any hematoma after blunt trauma must be fully “evaluated” and a careful vascular exam must be undertaken. When the vascular injury is acute as a result of trauma, the typical interventions include an open repair either with an interposition graft or reverse saphenous vein graft. We report a case of a delayed traumatic axillary artery dissection with resultant pseudoaneurysm treated with endovascular stent-grafting.

Highlights

A Challenging Surgical Case of Axillary Artery Pseudoaneurysm Weeks after Blunt Trauma
Axillary artery injury is a rare complication of blunt upper extremity trauma and is reported in the literature on only a few cases
We immediately ordered a physiologic ultrasound of his upper extremities which revealed satisfactory waveforms but a borderline pressure drop between the left upper arm and forearm. He had a computed tomography angiogram (CTA) that revealed a 4.1 x 3.3 cm pseudoaneurysm arising from the left axillary artery with an associated axillary hematoma measuring 8 x 8 x 10 cm

Summary

Introduction

A Challenging Surgical Case of Axillary Artery Pseudoaneurysm Weeks after Blunt Trauma Axillary artery injury is a rare complication of blunt upper extremity trauma and is reported in the literature on only a few cases. When the vascular injury is acute as a result of trauma, the typical interventions include an open repair either with an interposition graft or reverse saphenous vein graft.

Results

Conclusion