Aneurysms of the Upper Limb: Review of an Experience.

INTRODUCTION: True arterial aneurysms of the upper limb are rare and their treatment is intended to avoid complications as distal embolization or compression of surrounding neurovascular structures. The purpose of this study is to review the experience in the surgical treatment of true arterial aneurysms of the upper limb.

METHODS: Retrospective study of patients with true arterial aneurysms of the upper limb surgically treated between January 2007 and August 2017. Nine patients were identified and data was collected regarding sex, age, past medical history, aneurysm's aetiology, surgical procedure, complications and the need for re-intervention.

RESULTS: From a total of nine patients, seven were male and two were female, with ages between 29 and 68 years old (medium age of 55,5). One of the patients had surgery twice because of two aneurysms of the upper limb. From a total of 10 cases, two were subclavian, one was axillary and seven were brachial aneurysms. Three of them had degenerative/idiopathic aetiology, one was associated to a cervical rib and six occurred in the setting of arteriovenous fistula or kidney graft. Three patients had emergent surgery and the others had elective surgery. All of them were submitted to aneurysmectomy. As 30-day complications, there were two haematomas, one compartment syndrome and two early graft occlusions. Four patients needed re-intervention. During the follow-up period, all the grafts initially preserved were patent. There were no further known complications or amputation procedures. One of the patients who had emergent surgery and presented with finger paresis remained with hypomotility after the surgery.

CONCLUSION: True arterial aneurysms of the upper limb are uncommon. In this review most of the aneurysms were found in patients with haemodialysis vascular access or kidney grafts. Despite the need for early re-intervention in some cases, the surgical treatment of true arterial aneurysms of the upper limb is a low morbidity procedure.