Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2024; 12(21): 4755-4761
Published online Jul 26, 2024. doi: 10.12998/wjcc.v12.i21.4755
Surgical treatment of a rare brachial artery aneurysm post-arteriovenous fistula closure after kidney transplant: A case report
Nahit Arda Demirkan, Yasemin Keskin, Hakan Sevinç, Ömer Arda Çetinkaya
Nahit Arda Demirkan, Hakan Sevinç, Ömer Arda Çetinkaya, Department of General Surgery, Ankara University School of Medicine, Ankara 06100, Türkiye
Yasemin Keskin, Department of General Surgery, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara 06100, Türkiye
Author contributions: Demirkan NA, Keskin Y, and Sevinç H contributed to manuscript writing and editing, and data collection; Çetinkaya ÖA, Keskin Y, and Sevinç H contributed to data analysis; Demirkan NA and Çetinkaya ÖA contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ömer Arda Çetinkaya, MD, PhD, Associate Professor, Department of General Surgery, Ankara University School of Medicine, Hacettepe Neighborhood, İbni Sina Hospital Academic Campus Building, Block K, Altındağ, Ankara 06100, Türkiye. omerardacetinkaya@yahoo.com
Received: March 23, 2024
Revised: May 17, 2024
Accepted: June 3, 2024
Published online: July 26, 2024
Processing time: 98 Days and 15.1 Hours
Abstract
BACKGROUND

Brachial artery aneurysms are defined as dilations greater than 50% of the normal diameter, which are rare among all peripheral arterial aneurysms. While they are often present as pseudoaneurysms, true brachial artery aneurysms are also detected rarely. In this case report, the surgical repair method of true brachial artery aneurysms, which is a rare condition, is explained.

CASE SUMMARY

Herein, we present a 61-year-old male patient with complaints of swelling and pain in the right arm antecubital region that had been progressing over 6 mo. Upon the diagnosis of a true brachial artery aneurysm associated with arteriovenous fistula, the aneurysm was surgically repaired with an autologous saphenous vein graft. The patient was discharged without any neurovascular complications postoperatively.

CONCLUSION

True brachial artery aneurysms are rare and there are not any recommendations for their management in the current literature. Even though the treatment of true aneurysms in this artery is primarily based on a surgical treatment, endovascular repair also might be an option.

Keywords: Brachial artery aneurysm, Arteriovenous fistula, Kidney transplantation, Surgical repair, Autologous vein interposition, Case report

Core Tip: Brachial artery aneurysm often presents as a mass in the upper extremity and is asymptomatic. Pain or neurological symptoms related to median nerve compression, as well as hand or digital ischemia due to thrombosis or distal embolization, may occur. While endovascular techniques have been described in the literature for treating pseudoaneurysms in the brachial artery, the treatment of true aneurysms in this artery is primarily based on a surgical approach involving aneurysm resection and the placement of autologous venous or prosthetic grafts. Based on our clinical experiences and as in the reported case, surgical repair is the appropriate treatment option that should be undertaken without delay to prevent upper extremity ischemic sequelae. However, due to the rarity of true brachial artery aneurysm occurrences and a lack of sufficient studies among the available treatment options, the matter remains open to discussion and maintains its relevance.