Aneurysm excision combined with vascular graft revascularization as treatment for upper limb pseudoaneurysm

Abstract

Objective To investigate the clinical outcomes of treating upper extremity pseudoaneurysm using aneurysm excision combined with vascular graft revascularization.Methods Twenty-three cases of upper limb pseudoaneurysm treated between September 2008 and June 2013 were involved.The cause of the pseudoaneurysm was trauma in 9 cases,vascular injury from uremia hemodialysis in 12 cases,and vascular injury from interventional procedures in 2 cases.The vessels affected were brachial artery in 11 cases,radial artery in 10 cases,and ulnar artery in 2 cases.The pseudoaneurysm along with its parent artery was resected microsurgically.The lesser or greater saphenous veins were harvested as grafts to reconstruct the resected vessel segrnent for limb revascularization.Results All 23 procedures were successful.There was no peri-operation period death.The patients were follow-up for 6 to 24 months with an average of 12.3 months.Postoperatively the pulsating mass disappeared.There was no recurrence of the pseudoaneurysm.Perfusion of the affected limbs was good.No distal limb ischemia and necrosis occurred.Delayed wound healing was noted in 1 case.Conclusion Diagnosis of upper extremity pseudoaneurysm can be made based on clinical signs and vascular color Doppler ultrasound.Once diagnosed,it should be surgically treated as soon as possible to avoid death resulted from aneurysm rupture and massive bleeding.Resection of the pseudoaneurysm along with its parent artery combined with vascular graft for revascularization is a good option for the treatment of upper limb pseudoaneurysm. Key words: Pseudoaneurysm; Surgical procedures,operative; Transplantation; Parent vessel