Mycotic aneurysm of the ulnar artery

A surgical case of excision of infected aneurysm arising from anterior interosseal artery following infectious endocarditis

Infected aneurysm (IA) of the anterior interosseal artery (AIA), the first branch of the ulnar artery, is an infrequent but serious complication of infectious endocarditis (IE). We report a successful case of excision of IA arising from AIA. In this case, the IA expanded and adhered to the ulnar artery, resulting in occlusion of the ulnar artery. Reconstruction of the ulnar artery was not needed by the preoperative evaluation and the intraoperative occlusion testing. We discuss surgical treatment of IA following IE in upper extremities.

Infected upper extremity aneurysms: a review

OBJECTIVES

To review the occurrence of mycotic aneurysm affecting upper extremity arteries.

DESIGN

Literature review.

MATERIALS AND METHODS

A MEDLINE search from 1950 until 2007 and an extensive manual search were carried out using bibliographies from relevant published papers including cases involving arteries distal to the subclavian.

RESULTS

A total of 149 cases (68 papers) were identified. The brachial artery was the most frequently reported site, mostly associated with drug abuse, catheterization procedures or endocarditis. Since 1950 arterial trauma (drug abuse or catheterization) was the commonest cause. Gram positive organisms were the most frequent microbes involved. Acknowledging a limited follow-up, most patients did well when surgical therapy was promptly instituted.

CONCLUSIONS

Infected upper extremity aneurysms have been rarely described. IV drug abusers are a unique high-risk group for mycotic aneurysms in the upper extremities, most importantly in the axillary and brachial arteries. When rapidly performed, arterial ligation, primary repair or reconstruction with autogenous conduits was associated with favorable outcomes.

[Pseudoaneurysm of the deep palmar arch due to infective endocarditis]

The authors report a case of mycotic pseudoaneurysm of the deep palmar arch in a complicated case of Staphylococcus aureus infective endocarditis. They review the literature to discuss the physiopathology, diagnosis and treatment of this rare complication.

Mycotic aneurysm of the palmar arch after endocarditis

Mycotic pseudoaneurysms of upper extremities are an infrequent complication of endocarditis. We describe a case of mycotic pseudoaneurysm of the superficial palmar arch in a patient who had acute bacterial endocarditis. We discuss operative and pathologic findings and briefly review the literature on the subject.