A rare case of a true (degenerative) axillary artery aneurysm, secondary to chronic usage of crutches and its surgical management

Abstract

Aneurysms of the axillary artery are rare but potentially dangerous lesions that threaten the upper extremity with vascular and neurologic compromise. These aneurysms may arise as an aneurysm or pseudoaneurysm secondary to trauma or iatrogenic complications, or as degenerative lesions but secondary to the chronic use of crutches is rare. Inappropriate placement of the patient’s body weight on the axillary pad by the crutch causes repetitive trauma to an axillary artery leading to stenosis or aneurysm formation. The signs and symptoms vary with the cause of the aneurysm. It may include mass effects with brachial plexus compression and thromboembolic events involving the hands and fingers. Treatment should be considered in most of these lesions to prevent spontaneous rupture or microembolisation to the extremity leading to ischemia, gangrene, and amputation of the affected extremity. Surgical resection of aneurysm remains mainstay treatment followed by either interposition graft or direct end to end anastomosis.