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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
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Management of upper extremity aneurysms: a systematic review
Salomé Kuntz1,2, Anne Lejay3,2,4, Yannick Georg1,2
1Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France.
Summary
Recommendations for diagnosing and managing upper extremity arterial or venous aneurysms are provided. Prompt diagnosis and imaging are crucial for effective treatment, with surgical excision and revascularization favored for arterial types.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Aneurysm Management
Background:
- Arterial and venous aneurysms of the upper extremity are rare but can lead to serious complications.
- Accurate diagnosis and timely management are essential for optimal patient outcomes.
Purpose of the Study:
- To provide evidence-based recommendations for the diagnosis and management of upper extremity arterial and venous aneurysms.
- To review current literature and synthesize findings on presentation, imaging, and treatment.
Main Methods:
- Systematic review of Medline and Cochrane databases (1988–2019).
- Inclusion of 144 publications (111 arterial, 33 venous aneurysms).
- Analysis of case reports focusing on presentation, imaging, and surgical outcomes.
Main Results:
- 162 arterial aneurysms (brachial most common) and 40 venous aneurysms (forearm most common) identified.
- Mass perception was the most common presentation for both types.
- Arterial aneurysms presented with thromboembolic complications (46.7%), while venous aneurysms showed arm swelling (27.5%) and pulmonary embolism (10.0%).
- Duplex ultrasonography (DUS) was the primary imaging modality, followed by CTA and MRA.
- Surgical treatment involved excision with revascularization for arterial aneurysms (77.2%) and resection without reconstruction for venous aneurysms (85.0%).
- Complication rates were 10.5% for arterial aneurysms and 0% for venous aneurysm resection.
Conclusions:
- Prompt diagnosis and appropriate preoperative imaging are critical for selecting the best treatment.
- Open resection with revascularization is the preferred treatment for arterial aneurysms, though endovascular options are emerging.
- Venous aneurysms necessitate excision without the need for reconstruction.
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