A True Distal Brachial Artery Aneurysm Treated with a Bifurcated Saphenous Vein Graft

Brachial artery aneurysms are rare, mostly consisting of false ones secondary to infectious, traumatic, or iatrogenic arterial lesions. True aneurysms of the brachial artery are even more uncommon. Here, we report a case of a 40-year-old fisherman, without any pathological antecedent, who presented with a painful pulsatile mass of the left anterior arm. There was a slight edema with no ischemic signs. The computed tomographic angiography revealed a true 3.7 × 4.2 × 6 cm aneurysm of the distal brachial artery, partially thrombosed, which extended to the bifurcation. A surgical repair was indicated. Intervention consisted of an aneurysmectomy with interposition of an autologous reversed bifurcated saphenous vein graft. Early outcome was good and a 1-year follow-up showed a patent graft with no aneurysmal recurrence. A review of the literature on this rare location of true artery aneurysm and treatment options is outlined in this work.