Rare Presentation of an Ulnar Artery Aneurysm in a Six-Month-Old Baby: Case Discussion

Surgical Treatment of True Arterial Aneurysms of the Hand: A Systematic Review

BACKGROUND

The present study evaluated the clinical features and safety of surgical strategies and treatments for true arterial aneurysms of the hand.

METHODS

A systematic search of the PubMed, Embase, Web of Science, Scopus, and CINAHL databases for clinical trials, case series, and case reports investigating true arterial aneurysms of the hand, published over the past 10 years, was performed. The inclusion criterion was surgical excision of arterial aneurysm, followed by arterial revascularization or ligation. Studies addressing pseudoaneurysms, mycotic aneurysms, conservative treatment, or no treatment were excluded. Summary level data regarding study characteristics and outcomes of amputation, neurological symptoms, number of preoperative vascular imaging examinations, and length of hospital stay were extracted.

RESULTS

Thirty-nine studies comprising 48 patients (mean [±standard deviation] age, 41.1 ± 22 years [range 0.5-80 years]; 39 [81.25%] male) were included. Thirty (62.5%) patients underwent only 1 preoperative examination and traumatic etiology was observed in 52.1% (n = 25). The most prevalent intervention was aneurysm excision, followed by arterial revascularization (n = 35 [72.9%]), with no amputations. Neurological symptoms were present in 8 (16.6%) subjects, with no difference between the revascularization and arterial ligation groups (odds ratio 3.36 [95% confidence interval 0.37-30.5]). The mean length of hospital stay was 1.44 days (range 0-4 days), with no difference between revascularization and arterial ligation (odds ratio 2.5 (95% confidence interval 0.10-62.6)).

CONCLUSIONS

This review did not find amputation rate outcomes associated with either technique, although similar neurological outcomes were observed. Nevertheless, the retrieved data were limited to those ensuring the safety of both procedures.

A traumatic ulnar artery aneurysm in an infant

Ulnar artery aneurysm is very rare in infancy. Only a few reports have been done. We report an 8-month-old baby with true ulnar artery aneurysm on her hypothenar eminence. She had no specific past medical history, but an episode of falling. We resected the pulsating mass compressing the ulnar nerve, utilizing a surgical microscope. Reconstruction of the vascular deficit was not performed. She presented no functional deficit of the hand and no evidence of growth disturbance so far. As hypothenar eminence is a susceptible part for repetitive strikes, and as vein is fragile to the pressure, bypassing arterial route with vein graft is not recommended unless there is no other option.